State Form 4160 - Application For Reinstatement
Download a blank fillable State Form 4160 - Application For Reinstatement in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete State Form 4160 - Application For Reinstatement with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1APPLICATION FOR REINSTATEMENT
CONNIE LAWSON
State Form 4160 (R13 / 6-12)
SECRETARY OF STATE
Approved by State Board of Accounts, 2007
BUSINESS SERVICES DIVISION
302 W. Washington St., Room E018
Indianapolis, IN 46204
Indiana Code 23-1-46-3 (for profit corporation)
T elephone: (317) 232-6576
Indiana Code 23-17-23-3 (for not-for-profit corporation)
NOTE:
THIS APPLICATION CANNOT BE ACCEPTED WITHOUT A CERTIFICATE OF CLEARANCE
Make check or money order
FOR REINSTATEMENT FROM THE INDIANA DEPARTMENT OF REVENUE.
payable to Secretary of State.
INSTRUCTIONS:
Application must include the following:
1. Certificate of Clearance: Issued by the Indiana Department of Revenue
2. Corporate Reports and Fees: Please call our information line at 317-232-6576 to learn what reports are due or
log onto the web site at
a. Up to and including 1995, Annual Reports filed every year.
Annual Report fee $15.00
b. Beginning with 1996, Biennial Reports filed every two (2) years.
Biennial Report fee $30.00
Corporations incorporated in an even year, file every even year.
Corporations incorporated in an odd year, file every odd year.
c. Nonprofit corporations file Annual Reports every year.
Nonprofit corporation Report fee $10.00
3. Reinstatement filing fee: $30.00 plus business entity report fee.
4. Present original and one copy to address in upper right corner of this form.
SECTION I - CORPORATE INFORMATION
Name of corporation
Date of incorporation (month, day, year)
Effective date of administrative dissolution (month, day, year)
SECTION II - AFFIDAVIT OF CORPORATE OFFICER OF DIRECTOR
The undersigned, being at least one of the principal officers or a director of the above-named corporation deposes and
says:
A. that the grounds for dissolution did not exist or have been eliminated, and;
B. that the Corporation's name satisfies the requirements of Indiana Code 23-1-23-1, or Indiana Code
23-17-5-1.
IN WITNESS WHEREOF, the undersigned being the ______________________________________________ of
Title
said corporation executes this application and verifies, subject to penalties of perjury, that the statements
contained herein are true, this __________ day of ______________________________________, 20 _________.
Signature
Printed name
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 801 - Application For Reinstatement And Request To Set Aside Revocation Or Forfeiture - Office Of The Secretary Of State Corporations Section
Legal
Form F0022 - Application For Reinstatement Following Administrative Dissolution/revocation - 1996
Legal
State Form 20234 - Application For Remission Of Fees For A Child Of A Disabled Veteran -application For Free Tuition For Children Of Pow/mia
Legal
State Form 8200 - Application For License To Operate A Health Faclity - Indiana State Department Of Health
Legal
Related Categories
Parent category: Legal