Form Wbt - Certificate Of Withdrawal Of Foreign Business Trust
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1Kentucky Secretary of State
T
G
REY
RAYSON
_____________________________________________________________________________________________________________
Division of Corporations
Certificate of Withdrawal of
WBT
B
F
USINESS
ILINGS
Foreign Business Trust
P.O. Box 718
Frankfort, KY 40602
(502) 564-2848
_____________________________________________________________________________________________________________
Pursuant to the provisions of KRS Chapter 386 the undersigned hereby cancels the registration on behalf
of the business trust named below and for that purpose submits the following statements:
1. The name of the business trust is _______________________________________________________
2. The state or country of organization is ___________________________________________________
3. The date the business trust was authorized to do business in Kentucky is _______________________
4. The Secretary of State may forward to the business trust at the following address any process served
on the Secretary of State:
____________________________________________________________________________________
Address
City
State
Zip Code
5. The business trust surrenders its authority to transact business in the Commonwealth.
6. The business trust revokes the authority of its registered agent to accept service of process on its
behalf and appoints the Secretary of State as its agent for service of process in any proceeding based on a
cause of action arising during the time it was authorized to transact business in the Commonwealth. The
business trust shall notify the Secretary of State in the future of any change in its mailing address.
________________________________________
Signature of Trustee
_______________________________________________________
Type or Print Name & Title
Date:_____________________________,20____
Please submit one original and one exact or conformed copy. The filing fee is $15.00. Please make your check
payable to the “Kentucky State Treasurer”.
Mailing Address
Office Location
Trey Grayson
Room 154, Capitol Building
Secretary of State
700 Capital Avenue
P. O. Box 718
Frankfort, KY 40601
Frankfort, KY 40602-0718
Our home page address is
Our phone number is 502-564-2848
WBT (06/07)
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