Secretary of State 
                                                                Business Programs Division 
                                                                            Business Entities 
                                                   1500 11th Street, Sacramento, CA 95814 
                                               P.O. Box 944260, Sacramento, CA 94244-2600 

                                                   Submission Cover Sheet

For faster service, file online at bizfileOnline.sos.ca.gov               . 

Instructions: 

• Complete and include this form with your paper submission. This information only will be
  used to communicate in writing about the submission, if needed. This form will be
  treated as correspondence and will not be made part of the filed document.

• Make all checks or money orders payable to the Secretary of State.

• In person submissions (excluding Statements of Information): $15 handling fee; do not include
  a $15 handling fee when submitting documents by mail.

• Standard processing time for submissions to this office is approximately 5 business days from
  receipt. All submissions are reviewed in the date order of receipt with online submissions
  given priority. For updated processing time information, visit
  www.sos.ca.gov/business/be/processing-dates.

Optional Copy and Certification Fees: 

• If applicable, include optional certification fees with your submission.

• For applicable certification fee information, refer to the instructions of the specific form you are
  submitting.

Contact Person: (Please type or print legibly) 

First Name:                                      Last Name: 

Phone (optional):  

Entity Information: (Please type or print legibly) 

Name:  

Entity Number (if applicable):  

Address: 

Comments

Submission Cover Sheet (REV 03/2022)                            Clear Form  Print Form

                    Secretary of State                          RA-100

                    Resignation of Agent For Service of Process 

There is No Fee for filing a Resignation of Agent Upon Whom Process 
May be Served 

Certification Fee (Optional) –   $5.00 

Note:  If the entity from which you are resigning is a corporation, 
limited liability company, or limited partnership, you can go to the 
California Business Search at bizfileOnline.sos.ca.gov to verify the 
exact name of the entity, entity file number, and that you are currently 
listed as agent for service of process. 
                                                                                    This Space For Office Use Only 

1. Entity Name (Enter the exact name of the entity from which you are resigning as agent for service of process.)

2. Entity Number      (Enter the Entity N  umber issued to the business entity by the California Secretary of State.)

3. Name of Resigning Agent for Service of Process               (Enter your name, or if the agent for service of process is a corporation,
                                                                enter the name of that corporation.) 

4. Statement of Resignation (The following statement declares your intent to resign as agent for service of process.  Do not alter.) 

The undersigned hereby resigns as agent upon whom process may be served in California for the above-
name entity. 

5. Read and Sign Below    (Office or title not required.  Do not use a computer generated signature.)

I declare I am the person who signed this document, which execution is my act and deed. 

 ___________________________________________________________________________ 
Signature of Resigning Agent for Service of Process or  
Signature of Representative of Resigning Agent,  ifthe agent for service of process is a corporation

RA-100 (REV 03/2022)                                                                                                 20 22California Secretary of State 
                                                                                                                          bizfileOnline.sos.ca.gov