Application For Certificate Of Withdrawal Form
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1SECRETARY OF STATE
Clear Form
STATE CAPITOL
500 E. CAPITOL AVE.
APPLICATION FOR
PIERRE, S.D. 57501
Print
CERTIFICATE OF WITHDRAWAL
(605)773-4845
FAX (605)773-4550
FILING FEE: $10
An Original and one exact or conformed copy must be submitted.
1. The name of the corporation is ________________________________________________________________________________________
_________________________________________________________________________________________________________________
2. It is incorporated under the laws of the state of ___________________________________________________________________________
is not transacting business in this state and it surrenders its authority to transact business in this state
3. It
.
revokes the authority of its registered agent to accept service on its behalf
4. It
.
The address of the corporation's principal office is:
5.
___________________________________________________________________
_________________________________________________________________________________________________________________
After the withdrawal of the corporation is effective, service of process is perfected pursuant to SDCL 47-1A-1510.
The statement may be signed by any authorized officer of the corporation.
Date: __________________
___________________________________________________
Signature
___________________________________________________
Printed Name
___________________________________________________
Title
foreignapplicationwithdrawal July 2005
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