Form Dscb:15-4129/6129-2 - Application For Termination Of Authority Foreign Corporation Page 2

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DSCB:15-4129/6129-2
.
6
Notice of its intention to withdraw from doing business in this Commonwealth was mailed by certified or
registered mail to each municipal corporation in which the registered office or principal place of business of
the corporation in this Commonwealth is located and official publication required by 15 Pa.C.S. § 4129(b) or
6129(b) has been effected.
7. Process in any action or proceeding upon any liability incurred before the filing hereof may be sent to the
following:
Number and Street
City
State
Zip
County
IN TESTIMONY WHEREOF, the undersigned
corporation has caused this Application for Termination of
Authority to be signed by a duly authorized officer thereof
this
day of
,
.
Name of Corporation
Signature
Title

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