Application Form By A Foreign Nonprofit Corporation For A Certificate Of Withdrawal From The State - Secretary Of State - State Of South Carolina

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STATE OF SOUTH CAROLINA
SECRETARY OF STATE
APPLICATION BY A FOREIGN NONPROFIT CORPORATION
FOR A CERTIFICATE OF WITHDRAWAL
FROM THE STATE OF SOUTH CAROLINA
TYPE OR PRINT CLEARLY IN BLACK INK
Pursuant to Section 33-31-1520 of the 1976 South Carolina Code of Laws, as amended, the undersigned
nonprofit corporation hereby applies for a certificate of withdrawal authorizing it to withdraw from the State
of South Carolina and to surrender its authority to transact business in the State of South Carolina. The
undersigned hereby appoints the Secretary of State as agent for service of process and commits to notify
the Secretary of State of any change in mailing address.
1.
The name of the foreign nonprofit corporation as filed in South Carolina:
_____________________________________________________________________________
2.
The corporation is incorporated under the laws of:______________________________________
(State or Country)
3.
The corporation received a certificate of authorization to transact business in South Carolina
dated: _______________________________________
Month
Day
Year
4.
The corporation is no longer transacting business in South Carolina.
5.
The corporation hereby surrenders its authority to transact business in the State of South
Carolina.
6.
The corporation revokes the authority of its registered agent in South Carolina to accept service
of process on its behalf and appoints the Secretary of State as its agent for service of process in
any action, suit, or proceeding based upon any cause of action arising during the time it was
authorized to do business in this State.
7.
The address to which the Secretary of State may mail a copy of any process against the
Corporation that may be served on him is
_____________________________________________________________________________
______________________________________________________________________________
8.
Unless a delayed date is specified, this application shall be effective upon acceptance
for filing by the Secretary of State (See Section 33-31-123(b) of the 1976 South Carolina Code of
Laws, as amended):
_____________________________________________________________________________
Date ______________________
______________________________________
Name of Corporation
______________________________________
Signature
______________________________________
Type or Print Name and Office

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