Nonprofit Corporation Application For Certificate Of Reinstatement Following Administrative Dissolution - Wyoming Secretary Of State

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NONPROFIT CORPORATION
APPLICATION FOR CERTIFICATE OF REINSTATEMENT
FOLLOWING ADMINISTRATIVE DISSOLUTION
Wyoming Secretary of State
Phone (307) 777-7311/7312
The Capitol Building, Room 110
Fax (307) 777-5339
200 W. 24th Street
E-mail: corporations@state.wy.us
Cheyenne, WY 82002-0020
A nonprofit corporation administratively dissolved under W.S. 17-19-1421 may apply to the secretary of
state for reinstatement within two (2) years after the effective date of dissolution.
1.
The name of the corporation is: _______________________________________________________
2.
The effective date of its administrative dissolution was: ____________________________________
3.
The grounds for dissolution have been eliminated.
4.
The corporation’s name satisfies the requirements of W.S. 17-19-401.
Date: __________________________
Signed: ________________________________________
************************************************************************************
Filing Fee: $10.00
Instructions:
1.
The document may be executed by Chairman of Board, President or another of its officers.
2.
If the corporation was administratively dissolved for failure to file its annual reports and pay
the annual license taxes, the delinquent reports must accompany this form along with double
the license tax for each delinquent year.
3.
The document shall be accompanied by one (1) exact or photo copy.
npreinad - Revised 9/2003

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