Application For Certificate Of Withdrawal Of Foreign Profit Corporation - Montana Secretary Of State - 2017

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Prepare, sign, and submit with an original signature and filing fee.
This is the minimum information required.
STATE OF MONTANA
(This space for Secretary of State use only)
APPLICATION for CERTIFICATE of WITHDRAWAL
of FOREIGN PROFIT CORPORATION
35-1-1037, MCA
MAIL:
Secretary of State
P.O. Box 202801
Helena, MT 59620-2801
PHONE:
(406) 444-3665
FAX:
(406) 444-3976
Required Filing Fees:
WEB SITE:
sos.mt.gov
Standard
$ 15.00
24 Hour Priority $ 35.00
Folder ID Number: _____________
1 Hour Expedite $115.00
The folder number begins with an “F” and may be
referenced at https://
Make checks payable to Secretary of State.
If the document is hand written, please print legibly or the application may be denied.
1. The name of the Corporation: ________________________________________________________________________________
2. The state, tribe, or country of incorporation:_____________________________________________________________________
3. The Corporation is not transacting business in Montana and it hereby surrenders its authority to transact business in Montana.
4. A certificate from the
Montana Department of Revenue
stating that all taxes imposed pursuant to
Title 15,
MCA, have been paid
must be attached. You may contact them at (406) 444-6900; PO Box 5805, Helena, MT 59620-5805.
5. The Corporation revokes the authority of its registered agent in Montana to accept service of process on its behalf and appoints
the Secretary of State as its agent for service of process in any proceeding based on a cause of action arising during the time it
was authorized to transact business in Montana.
6. Provide a business mailing address to which the Secretary of State may mail a copy of any process against the Corporation
served on the Secretary of State:
_________________________________________________________________________________________________________
City: __________________________________________ State: ________________________ Zip Code:_____________________
7. The Corporation will notify the Secretary of State should any other changes be made in its mailing address.
8. OPTIONAL – The reason for filing this withdrawal: ________________________________________________________________
9. I, HEREBY SWEAR AND/OR AFFIRM, under penalty of law, including criminal prosecution, that the facts contained in this
document are true.
__________________________________________________________________________
____________________________
Signature of Presiding Officer of the Board of Directors, President, or other Officer
Date
____________________________________________________________
___________________________________________
Printed Name
Title
10. Daytime Contact: Phone ________________________________ Email_______________________________________________
sos.mt.gov/Business/Forms
46-Certificate_of_Withdrawal_of_Foreign_Profit_Corporation
Revised: 3/2017

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