Application For Reinstatement Form - Department Of Commerce Division Of Corporations & Commercial Code - State Of Utah
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1State of Utah
File Number:
Department of Commerce
Division of Corporations & Commercial Code
Check Here If:
Non-Refundable Fee
Profit Corporation
$50.00
[ ]
Non-Profit Corporation
$20.00
[ ]
[ ]
Limited Partnership
$50.00
Limited Liability Company
$50.00
Application for Reinstatement
[ ]
(Business Entity Name)
I,
hereby declare and affirm that
(Print Name)
I am a
of
,
(Officer, General Partner, or Member)
( Business Name )
which was involuntarily dissolved or canceled on the
day of
, 20
, under provisions of Utah
law.
I hereby remedy all prior defaults and file herewith a current annual report together with the required annual report
and statutory reinstatement fee.
I hereby make application for reinstatement and request the Division of Corporations and Commercial Code of the
State of Utah to issue a Certificate of Reinstatement and, under penalties of perjury, I declare that the foregoing
statement is, to the best of my knowledge and belief, true and correct.
*If the above mentioned corporation name is not available for use at the time of reinstatement, the following
corporation name shall be used:
(New Corporation Name)
:
By
Title
Phone Number:
:
(Signature)
Submit with this application
a completed Registration Information Change Form showing the new registered agent and
Agent’s signature. Enclose a tax letter of Good Standing from the Utah Tax Commission (only applicable to Corporation-Domestic-
.
Profits)
Payment:
You may file in person, by mail or by fax. Means of payment are, cash, check, or money order payable to the “State of
Utah”. Please include one (1) self addressed envelope with application. If you are faxing you must include, on a cover sheet, the
number of a Visa or MasterCard with the date of expiration.
FREE! You may visit our Web Site to access this document and other information.
nd
160 East 300 South 2
FL, Box 146705
Mail In:
Salt Lake City, Utah 84114-6705
Walk In: 160 East 300 South Main Floor
Corporation’s Information Center: (801) 530-4849
Toll Free Number: (877) 526-3994 (Utah Residents)
Fax: (801) 530-6111
Web Site:
common\forms\Misc\cmborein
Revised: 03-26-01 mm
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