Form F0022 - Application For Reinstatement Following Administrative Dissolution/revocation - 1996

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F0022 - Page 1 of 2
OFFICE OF THE MISSISSIPPI SECRETARY OF STATE
P.O. BOX 136, JACKSON, MS 39205-0136
(601) 359-1333
*0022-1-2*
Application for Reinstatement
Following Administrative Dissolution/Revocation
This application is submitted to the Office of Secretary of State of Mississippi for Reinstatement.
1. Name of Corporation
2. Federal Tax ID number
3. Corporate ID number
4. Date of Administrative Dissolution/Revocation
5. The grounds for Dissolution/Revocation
did not exist or
have been eliminated.
(Complete and mark appropriate box)
6. The corporate name satisfies the requirements of the Mississippi Business Corporation Act.
Note: Certification from the Mississippi State Tax Commission stating that all taxes owed by the
corporation have been paid must accompany this application.
This application must be executed in the name of the corporation by the chairman of the board of
directors, the president or another of the officers.
(Please keep writing within blocks)
By:
Signature
Printed Name
Title
Date
Filing Fee $50.00 for Domestic Corporations
Filing Fee $100.00 for Foreign Corporations
Rev. 01/96

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