Sfn 58788 - Nonprofit Corporation Articles Of Dissolution Form

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COMPLETE, PRINT, SIGN, AND FAX OR MAIL

(If paying with credit card complete authorization at bottom of page 3)

FOR OFFICE USE ONLY

NONPROFIT CORPORATION

ID Number

ARTICLES OF DISSOLUTION

WO Number

SECRETARY OF STATE

SFN 58788

(08-2008)

Filed

1. FILING FEE $20.00

For reference, see N.D.C.C., Sections 10-33-100 through 10-33-103

TYPE OR PRINT LEGIBLY

SEE REVERSE SIDE FOR FEES, FILING AND MAILING INSTRUCTIONS.

2. The Name of the Corporation

3. Federal ID Number

4. The dissolution shall be effective

When Articles of Dissolution are filed with the Secretary of State.

Later on _____________________________________________.

(month, day, year)

5. "The undersigned states that if applicable, the corporation has notified the attorney general as required by N.D.C.C., section 10-33-122 and the waiting

period has expired or has been waived by the attorney general; and

The corporation: (check the appropriate box)

Did not give notice to creditors and claimants. The Intent to Dissolve was filed with the Secretary of State.

Payment of claims of all known creditors and claimants has been made or adequate provision has been made

for payment or discharge, OR

Two years have elapsed since filing the Intent to Dissolve with the Secretary of State.

Any remaining property, assets, and claims of the corporation have been distributed in accordance with North Dakota

law, or adequate provisions have been made for that distribution.

There are no pending legal, administrative, or arbitration proceedings by or against the corporation, or adequate

provision has been made for the satisfaction of any judgment, order or decree that may be entered against it in a

pending proceeding.

Gave notice to creditors and claimants on ___________________________. Payment of claims filed by creditors and

(month, day, year)

claimants has been made or provided for and the longest of the periods defined in N.D.C.C., Section 10-33-101,

Subsection 3b and as herein provided, have elapsed:

60 days have elapsed since a claim was rejected and the claimant has not pursued other remedies;

180 days have elapsed since the corporation filed the Intent to Dissolve with the Secretary of State; OR

90 days have elapsed since notice was given to creditors and claimants.

Any remaining property, assets, and claims of the corporation have been distributed in accordance with North Dakota law,

or adequate provisions have been made for that distribution.

There are no pending legal, administrative, or arbitration proceedings by or against the corporation, or adequate provision

has been made for the satisfaction of any judgment, order or decree that may be entered against it in a pending

proceeding."

6. "The undersigned, a person authorized by the corporation to sign the Articles of Dissolution, has read the foregoing articles, knows the contents thereof,

and believes the statements made thereon to be true. I further authorize the Secretary of State to correct number 2 if not correctly reflected."

__________________________________________________________

(Signature)

(Date)

Daytime Telephone Number

7. Name of person to contact if questions about this document

E-mail Address