File No.
STATE OF NORTH CAROLINA
                                                                                     In The General Court Of Justice
                                                County                                       Superior Court Division
                                                                                             Before The Clerk
          IN THE MATTER OF THE ESTATE OF
Name Of Decedent/Incompetent

                                                                                     APPOINTMENT OF
                                                                                     RESIDENT PROCESS AGENT

                                                                                                                                 G.S. 28A-4-2(4); 35A-1213(b)
I, the qualified personal representative or guardian of the above named estate, submit to the jurisdiction of the North Carolina Courts 
in the above captioned matter, and appoint the resident process agent named below on whom may be served citations, notices and 
processes in all actions or proceedings with respect to this estate.
Name, Street Address, PO Box, City, State And Zip Code Of Resident Process Agent Date

                                                                                 Name Of Personal Representative Or Guardian (type or print)

Telephone                   County Of Residence                                  Signature Of Personal Representative Or Guardian

                                          ACCEPTANCE OF APPOINTMENT
I accept this appointment as resident process agent for the above named personal representative or guardian, and agree to notify the 
personal representative or guardian of all citations, notices and processes served on me as his or her resident process agent.
Date                Name Of Resident Process Agent (type or print)                   Signature Of Resident Process Agent

AOC-E-500, Rev. 6/21
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