Application For Reinstatement - South Dakota Secretary Of State
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SECRETARY OF STATE
STATE CAPITOL
APPLICATION FOR REINSTATEMENT
Information
500 E. CAPITOL AVE.
PIERRE, S.D. 57501
(605)773-4845
Fax (605)773-4550
1. The name of the corporation is ____________________________________________________________
2. The date of its administrative dissolution ____________________________________________________
3. State that the ground or grounds for dissolution either did not exist, or have been eliminated by filing all
required reports and paying all fees and penalties _____________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
4. The corporation's name satisfies the requirements of chapter 47-2.
5. Attached hereto is a certificate from the Department of Revenue reciting that any taxes owed by the
corporation have been paid.
Application may be signed by the chairman of the board of directors, the president or any other officer.
Dated _______________________.
_____________________________________
(Signature)
_____________________________________
(Title)
STATE OF ___________________________
__________________________
COUNTY OF
I, ______________________________, a notary public, do hereby certify that on this _____ day of _______________20_____,
personally appeared before me ________________________________________________ who, being by me first duly sworn,
declared that he/she is the ____________________________ of _____________________________________________, that
he/she signed the foregoing document as officer of the corporation, and the statements therein contained are true.
____________________________
_______________________________________
My Commission Expires
(Notary Public)
Notarial Seal
FILING FEE: $125
Submit one original and one exact or conformed copy for filing with the certificate from the Department of
Revenue and all delinquent annual reports, filing fees and penalties.
revised 7/04
DBAPRI.PDF
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