Form 401-A – Acceptance of Appointment and Consent to Serve as Registered Agent Unique IDAre you filing as an individual or an organization?(Required) Individual Organization Acceptance of Appointment and Consent to Serve as Registered AgentName of represented entity(Required)I acknowledge, accept and consent to my designation or appointment as registered agent in Texas for:Name of organization designated as registered agent(Required)I am authorized to act on behalf of:Name of represented entity(Required)The organization is registered or otherwise authorized to do business in Texas. The organization acknowledges, accepts and consents to its appointment or designation as registered agent in Texas for:I am a resident of the state and understand that it will be my responsibility to receive any process, notice, or demand that is served on me as the registered agent of the represented entity; to forward such to the represented entity; and to immediately notify the represented entity and submit a statement of resignation to the Secretary of State if I resign. The organization takes responsibility to receive any process, notice, or demand that is served on the organization as the registered agent of the represented entity; to forward such to the represented entity; and to immediately notify the represented entity and submit a statement of resignation to the Secretary of State if the organization resigns.Signature of registered agent(Required)Signature of person authorized to act on behalf of organization(Required)Printed name of registered agent(Required)Printed name of authorized person(Required)Date (mm/dd/yyyy)(Required) MM slash DD slash YYYY go back to registered agent delegation
