Form Diss Stk - Certificate Of Dissolution - California Secretary Of State
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1DISS STK
Secretary of State
Certificate of Dissolution
(California Stock Corporation ONLY)
IMPORTANT —
Read Instructions
before completing this form.
There is No Fee for filing a Certificate of Dissolution - Stock
Copy Fees – First page $1.00; each attachment page $0.50;
Certification Fee - $5.00 plus copy fees
This Space For Office Use Only
1. Corporate Name
2. 7-Digit Secretary of State File Number
(Enter the exact name of the Corporation as it is recorded
with the California Secretary of State.)
3. Election
The dissolution was made by a vote of ALL of the shareholders of the California corporation.
Note: If the above box is not checked, a Certificate of Election to Wind Up and Dissolve (Form ELEC STK) must be filed prior to
or together with this Certificate of Dissolution. (California Corporations Code section 1901.)
(Check the applicable statement. Only one box may be checked. If second box is checked, must
4. Debts and Liabilities
include the required information in an attachment.)
The known debts and liabilities have been actually paid or paid as far as its assets permitted.
The known debts and liabilities have been adequately provided for in full or as far as its assets permitted by their
assumption. Included in the attachment to this certificate, incorporated herein by this reference, is a description
of the provisions made and the name and address of the person, corporation or government agency that has
assumed or guaranteed the payment, or the depository institution with which deposit has been made.
The corporation never incurred any known debts or liabilities.
5. Required Statements
(Do not alter the Required Statements – ALL must be true to file Form DISS STK.)
a. The Corporation has been completely wound up and is dissolved.
b. All final returns required under the California Revenue and Taxation Code have been or will be filed with the
California Franchise Tax Board.
c.
The known assets have been distributed to the persons entitled thereto or the corporation acquired no known
assets.
6. Read, Verify, Date and Sign Below
(See Instructions
for signature requirements.)
The undersigned is the sole director or a majority of the directors now in office. I declare under penalty of perjury
under the laws of the State of California that the matters set forth in this certificate are true and correct of my own
knowledge.
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___________________________________________
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Date
Signature
Type or Print Name
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__________________________________________
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Date
Signature
Type or Print Name
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Date
Signature
Type or Print Name
2016 California Secretary of State
DISS STK (REV 12/2016)
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