Form Fpr-Wd - Application For Certificate Of Withdrawal - 2013

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325 Don Gaspar, Suite 300 ∙ Santa Fe, NM 87501
(800) 477-3632 ∙
SUBMIT ORIGINAL AND A COPY
TYPE OR PRINT LEGIBLY
Foreign Profit Corporation
APPLICATION FOR CERTIFICATE OF WITHDRAWAL
The undersigned corporation, in order to apply for a Certificate of Withdrawal under the
New Mexico Business Corporation Act, submits the following statement to the Secretary of State:
1. The name of the corporation is (include NM CORP#):___________________________
_______________________________________________________________________
2. It is incorporated under the laws of:___________________________________
3. It is not transacting business in New Mexico. It surrenders its authority to transact
business in New Mexico. It revokes the authority of its registered agent in New
Mexico to accept service of process, and consents that service of process in any
action, suit or proceeding based upon any cause of action arising in New Mexico
may thereafter be made on it by service thereof on the Secretary of State of New
Mexico.
4. The mailing address to which the Secretary of State of New Mexico may mail a copy
of any process against the corporation that may be served on it is:
_______________________________________________________________________
_______________________________________________________________________
5.The aggregate number of shares which it has authority to issue as of the date of this
application, itemized by class and series, if any, within each class is:
6. The aggregate number of shares that have been issued as of the date of this
application, itemized by class and series, if any, within each class is:

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