(Department of Business Oversight Use Only) | Department of Business Oversight File No., if any | |
___________________________Fee Paid $ | ___________________________ | |
___________________________Receipt No. | (Insert File Number(s) of Previous Filings Before the Department, if any) |
FEE: $600
(See Corporations Code Section 25608(z))
COMMISSIONER OF BUSINESS OVERSIGHT STATE OF CALIFORNIA
NOTICE OF EXCHANGE TRANSACTION OR ENTITY CONVERSION PURSUANT TO CORPORATIONS CODE SECTION 25103(h)
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Street | City | State | ZIP | |||
(b) Mailing address: | ______________________________________________________ | |||||
Street | City | State | ZIP |
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() Section 25103(h)(1)(A) of the Code.
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() Section 25103(h)(1)(B) of the Code, and the state of incorporation or organization is
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, or the form of the organization is
.
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() | Check if acquiring or converting | Acquiring or converting entity |
entity has a consent to service of | ___________________________ | |
process on file with the | ||
Commissioner | Authorized signature on behalf of acquiring or converting entity | |
___________________________ | ||
Print Name and Title of Signatory |
Name, Address and Phone Number of Contact Person:
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Instructions: Each acquiring or converting entity (other than a California corporation) filing a notice under Section 25103(h) must file a consent to service of process (Form 260.165), unless it already has a consent to service on file with the Commissioner.
260.103.6 (9/09)
Cal. Code Regs. Tit. 10, § 260.103.6
2. Amendment of section, form and NOTE filed 5-20-97; operative 5-20-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 21).
3. Amendment of section and NOTE filed 9-23-2009; operative 10-23-2009 (Register 2009, No. 39).
4. Change without regulatory effect amending form within subsection (b) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
Note: Authority cited: Sections 25165 and 25610, Corporations Code. Reference: Sections 25103(h), 25165 and 25608(z), Corporations Code.
2. Amendment of section, form and Note filed 5-20-97; operative 5-20-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 21).
3. Amendment of section and Note filed 9-23-2009; operative 10-23-2009 (Register 2009, No. 39).
2. Amendment of section, form and Note filed 5-20-97; operative 5-20-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 21).
3. Amendment of section and Note filed 9-23-2009; operative 10-23-2009 (Register 2009, No. 39).
4. Change without regulatory effect amending form within subsection (b) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).
2. Amendment of section, form and Note filed 5-20-97; operative 5-20-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 21).
3. Amendment of section and Note filed 9-23-2009; operative 10-23-2009 (Register 2009, No. 39).
4. Change without regulatory effect amending form within subsection (b) filed 8-13-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 33).