FW
Foreign Corporation Certificate of Withdrawal
All information must be completed or this document will not be accepted for filing.
Name must match the name on record with the Secretary of State
(Address must be a street
Do not write in this space
address. A post office box is unacceptable.)
___________________________________________________________________________________________
Street Address
City
State
Zip Code
Day
Month
Year
_________________________________________________
__________________________________________
President or Vice President
Secretary or Assistant Secretary
INSTRUCTIONS:
Contact Information
Ron Thornburgh
Rev. 7/01 hb
K.S.A. 17-7306