Foreign Business Corporation - Withdrawal And Final Report Application - Instructions

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FOREIGN BUSINESS CORPORATION – WITHDRAWAL
AND FINAL REPORT APPLICATION
<RXU return address and phone number during the day: (
____________
) ______ -
INSTRUCTIONS (Ref. sec. 180.1520, Wis. Stats. for document content)
Submit one original and one exact copy to Department of Financial Institutions, P O Box 7846,
Madison WI, 53707-7846, together with the filing fee of $40.00, or more, as computed in section III,
payable to the department. (If sent by Express or Priority U.S. mail, address to 345 W. Washington
rd
Ave., 3
Floor, Madison WI, 53703). This document can be made available in alternate formats upon
request to qualifying individuals with disabilities. The original must include an original manual
signature, per sec. 180.0120(2), Wis. Stats. Upon filing, the information in this document becomes
public and might be used for purposes other than those for which it was originally furnished. If you
have any questions, please contact the Division of Corporate & Consumer Services at 608-261-7577.
Hearing-impaired may call 608-266-8818 for TDY.
I. Enter the name of the corporation and the state in which it is incorporated. If the corporation is
licensed in this state under a fictitious name, provide the fictitious name as well.
A, B & C. These statements are required by sec. 180.1520(2)(b) and (c).
D. If the address of the corporation’s principal office has changed from that indicated on its most
recent annual report, provide the new address in item D.
II. Provide complete information to all items in section II. Post the figure from line II A. (11) to line
III A. in section III.
III. The filing fee is the sum of the base filing fee of $40.00, plus any additional amount that may be
due on an increase in capital representation during the final report period on which fee has not been
paid. The fee computed at the rate of $2.00 per $1,000 (or any part thereof) of the increase. (Note:
The corporation has, as a result of obtaining a certificate of authority, paid on at least $25,000 of
capital representation. It may have paid more at its initial qualification, or may have paid on increases
in capital representation disclosed on its Foreign Corporation Annual Reports filed over the term of its
qualification. If this figure is unknown to the preparer, call the department and ask for the amount of
capital representation on which the corporation has paid fee. 608-261-7577.)
IV. The application is to be executed by an officer of the corporation. Print or type the name and title
of the officer signing the application and the date it was signed.
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DFI/CORP/
I(R5/99)
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