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Enter the name and mailing address to which any correspondence regarding this filing should be sent. Statement of Change takes the following effect: (select only one).Appoints New Agent (complete section 5). 6.3 REQUIRED – if you are appointing a new statutory agent, the Statutory Agent Acceptance form M002 must be submitted along with this Statement of Change form. NAME OF ENTITY - REQUIRED: (Must match our records exactly. A statement appointing an agent for service of process takes effect on filing. 3. If handwritten, the form must be legible and completed in black or blue-black ink in order to permit reproduction. Agent for this corporation. You must agree with the statement if you're using a registered agent. Also, foreign LLCs must complete section 5.