Form Fcw - Application For Certificate Of Withdrawal With Instructions (Page 2 of 2) in pdf

Form Fcw - Application For Certificate Of Withdrawal With Instructions Page 2

Application for Certificate of Withdrawal Filing Instructions

TYPE OF CORPORATION

The corporation must indicate if it is a business corporation (KRS 271B), a nonprofit corporation

(KRS 273), or a professional service corporation (KRS 274) by checking the appropriate box.

NAME OF CORPORATION

Use the exact name of the corporation or the fictitious name adopted if "real name" was

unavailable for use when the corporation applied for authority to transact business in Kentucky.

STATE OF INCORPORATION

Indicate the state or country of incorporation.

DATE AUTHORIZED

State the date that the corporation first received authority to transact business in Kentucky.

EFFECTIVE DATE AND TIME

The document will be effective on the date and time of filing, unless a delayed effective date

and/or time is specified. A delayed effective date may not be later than the 90

day after the date

of filing.

WHO MAY SIGN

An officer of the corporation or the chairman of the board of directors must sign the application for

certificate of withdrawal. The person executing the document shall state his or her title or capacity

in which he or she signs.

NUMBER OF COPIES

Submit the original signed application and two exact or conformed copies. (May be photocopies.)

Two file-stamped copies will be returned to the corporation as evidence of filing. One file-

stamped copy must be filed with the county clerk of the county in which the corporation’s

registered office was situated.

NOTE: Your file-stamped copy shall serve as the Certificate of Withdrawal.

FILING FEES

The filing fee for a business corporation or a professional service corporation is $40.00.

The filing fee for a nonprofit corporation is $8.00.

Your check should be made 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

WEB SITE ADDRESS

Our home page address is

Click on “On Line Business Database” for information on status of all business entities in

Kentucky. Forms are also available on our web site.

For information, please call (502) 564-2848, press 2, and then press 5 or try our web site.

NOTE: The corporation must be in "good standing" upon the records of the Secretary of State’s

Office before current statements or documents can be filed (30 KAR 1:010).

Form Fcw - Application For Certificate Of Withdrawal With Instructions Page 2

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