Application And Petition For Reinstatement Of Certificate Of Registration Form - District Of Columbia

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DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS
BUSINESS REGULATION ADMINISTRATION
CORPORATIONS DIVISION
Government
941 NORTH CAPITOL STREET, N.E.
of the
WASHINGTON, D.C. 20002
District of Columbia
APPLICATION AND PETITION FOR REINSTATEMENT OF
CERTIFICATE OF REGISTRATION
To:
DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS
BUSINESS REGULATION ADMINISTRATION
CORPORATIONS DIVISION
941 NORTH CAPITOL STREET, N.E.
WASHINGTON, D.C. 20002
Pursuant to the provisions of Title 29, Chapter 3 of the Code of Laws of the District of Columbia, the
undersigned limited liability company hereby petitions and applies for a Certificate of Reinstatement of a
proclaimed foreign limited liability company, and hereby certifies as follows:
FIRST: The name of the limited liability company at the time of publication of the proclamation was:
_________________________________________________________________________________________.
SECOND: The new name by which the limited liability company will hereafter be known is
_________________________________________________________________________________________.
THIRD: The Certificate of Organization was revoked on November ___ , 20 ___, for failure and/or refusal to
file any annual reports for two consecutive years, next proceeding September 30, 20 ____.
FOURTH: The address, including street and number, if any of its registered office in the District of Columbia
is:
______________________________________________ and the name of its registered agent in the District of
Columbia at such address is:
_________________________________________________________________________________________.
FIFTH: This application and petition is accompanied by all delinquent reports together with the filing fees
and penalties required by the Code of Laws of the District of Columbia.
Date: ______________, 20___.
__________________________________________________
Name of limited liability company
By _______________________________________________
(Authorized Manager or Member)

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