Louisiana Secretary of State – Notice of Change of Registered Office and/or Change of Registered Agent (Domestic Limited Liability Company) (R.S. 12:1308) (Form SS983, Rev. 01/24) Instructions

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This form contains 28 fields organized into 14 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Agent Affidavit - Registered Agent(s)
Registered Agent Signature Text
Enter the signature of the registered agent acknowledging and accepting appointment on behalf of the company.
Max length: 35 characters
Registered Agent Printed Name Text
Enter the printed name (and title, if applicable) of the registered agent who is acknowledging and accepting the appointment.
Max length: 33 characters
Business Name
Business Name Text
Enter the full legal business name exactly as it appears on official documents (include punctuation and suffixes such as LLC, Inc., etc.).
Max length: 85 characters
Change of Location - New Registered Office Address
New Registered Office Address Text
Enter the complete new registered office address for the LLC, including street address (and suite/unit if applicable), city, state and ZIP code.
Max length: 63 characters
Change of Location - Signature and Date
Member/Manager Signature Text
Enter the signature of a member or manager authorizing the change of the registered office (include printed name if required).
Max length: 37 characters
Signature Date Date
Enter the date on which the member or manager signed to authorize the change of registered office.
Max length: 3 characters
Change of Registered Agent(s) - New Agent Name/Address
New Registered Agent(s) Name and Address Text
Enter the full name(s) of the new registered agent(s) followed by their complete mailing address (street address, city, state, and ZIP code) as it should appear on file.
Change of Registered Agent(s) - Signature and Date
Signature of Manager or Member Text
Enter the printed name or handwritten signature of the manager or member who is authorizing the change of registered agent(s).
Max length: 34 characters
Signature Date Date
Enter the date when the manager or member signed to authorize the change of registered agent(s).
Max length: 3 characters
City / State / ZIP
Address Line 1 Text
Enter the primary street address or P.O. Box for the business as it appears in documents.
Max length: 29 characters
Address Line 2 Text
Enter secondary address information such as suite, apartment, unit number, building name, or other address details.
Max length: 25 characters
Address Line 3 Text
Enter any additional address information or continuation of the street address if needed.
Max length: 25 characters
City Text
Enter the city for the mailing address.
Max length: 41 characters
ZIP Code Text
Enter the mailing ZIP or postal code for the address.
Max length: 28 characters
Contact Phone / Fax / Email
Daytime Phone Number Text
Enter the primary daytime telephone number where the contact can be reached, including area code and any necessary extension.
Max length: 29 characters
Fax Number Text
Enter the fax number for the contact, including area code if applicable.
Max length: 24 characters
Email Address Text
Enter the contact's email address where correspondence and evidence of filing should be sent.
Max length: 23 characters
Filer Name
Filer Business Name Text
Enter the business name exactly as it appears on your official documents; this is the name that will be used on the filing.
Max length: 80 characters
General
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Max length: 78 characters
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Max length: 70 characters
Limited Liability Company Name
Limited Liability Company Name Text
Enter the full legal name of the limited liability company exactly as it appears (or should appear) on the formation records.
Max length: 74 characters
Notary - Date and Notary Signature
Notary Date Date
Enter the date the notary public swore and subscribed to the document (the date the notarial act was performed).
Max length: 17 characters
Notary Signature Text
Enter the notary public's signature acknowledging the affidavit; also include or separately provide the notary's printed name and notary number where required.
Max length: 35 characters
Service and Payment Options
Routine Checkbox
Check this box to request standard routine processing (no expedited fee).
Expedite $30 Checkbox
Check this box to request 24-hour expedited processing and indicate you will pay the $30 expedite fee.
Priority Expedite $50 Checkbox
Check this box to request 2–4 hour priority expedited processing and indicate you will pay the $50 priority expedite fee.
Check or Money Order Enclosed Checkbox
Check this box if you are enclosing a check or money order as payment for the filing.
Street Address
Street Address Text
Enter the full street address for mailing (street number, street name, and any apartment/suite/unit info) as a single line.
Max length: 75 characters