DS-DE 41 Save Miami Beach 0
REGISTERED AGENT OFFICE USE ONLY
STATEMENT OF APPOINTMENT
(Section 106.022, F.S.)
2015 JE 22 PM 2: 22
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Original Appointment ❑ Change of Appointment
❑ Change of Mailing Address ❑ Change of Physical Address
Registered Agent and Office information
Name Telephone
Stephen Cody 786-252-6918
Street Address
16610 SW 82nd Court
City State Zip Code
Miami FL 33157
Mailing Address
Same
City State Zip Code
I accept this appointment and confirm that I am familiar with and accept the obligations of the position as set
forth in Section 106.022, F.S. I al. understand that I may resign this appointment by executing a written
stat-• - of resign do an. f i • it the applicable filing officer.
is' t fir
Signatur of Registered Agent Date
For a Registered Agent and Office Information (for changes only)
Name Telephone
Street Address
City State Zip Code
Committee or Organization information
Name of Committee or Organiz i11 4
IN
Street Address Telephone
City State Zip Code
M4 - 94
1 iv° .
Signatu"of Chairperson
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Printed Name of Chairperson Date
Form DS-DE 41 (revised 6/11)
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