SW6230606_Signing Official Title & Position Information_20230731

SOSID: 0011922
Date Filed: 7/31/2023 10:04:00 AM
STATE OF NORTH CAROLINA Elaine F.Marshall
DEPARTMENT OF THE SECRETARY OF STA
North Carolina Secretary of State
C2023 201 00515
STATEMENT OF CHANGE OF REGISTERED
OFFICE AND/OR REGISTERED AGENT
Pursuant to §55D-31 of the General Statutes of North Carolina, the undersigned entity submits the following for the purpose of
changing its registered office and/or registered agent in the State of North Carolina.
INFORMATION CURRENTLY ON FILE
The name of the entity is: Benhaven Emergency Services, Inc.
The street address and county of the entity's registered office currently on file is:
Number and Street: 66 Quail Hollow
City: Cameron State: NC Zip Code. 28326 County: Harnett
The mailing address if different from the street address of the registered office currently on file is:
Number and Street:
City: State: NC Zip Code: County:
George W Williams, Sr.
The name of the current registered agent is:
NEW INFORMATION
1. The street address and county of the new registered office of the entity is:
(complete this item only if the address of the registered office is being changed)
Number and Street: 4023 N. Carolina Highway 87 North -
City: Sanford State: NC Zip Code: 27332 County: Harnett
2. The mailing address if different from the street address of the new registered office is:
(complete this item only if the address of the registered office is being changed)
Number and Street: PO BOX 301
City: Olivia State: NC Zip Code: 28368 County: Harnett
3. The name of the new registered agent and the new agent's consent to appointment appears below:
(complete this item only if the name of the registered agent is being changed)
Gary Briggs is
Type or Print Name of New Agent ignature&Title
4. The address of the entity's registered office and the address of the business office of its registered agent,as changed,
will be identical.
5. This statement will be effective upon filing,unless a date and/or time is specified:
This is the 12 day of June 2023 Benhaven Emergency Services, Inc.
Signature
Luann Miller,Secretary
Notes: Filing fee is$5.00. This document must be Filed with the Secretary of State. Type or Print Name and Title ^
* Instead of signing here,the new registered agent may sign a separate written consent to the appointment,which must be attached to this statement.
BUSINESS REGISTRATION DIVISION P.O.BOX 29622 RALEIGH,NC 27626-0622
Revised July 2017 Form BE-06