Form Corp. 47 - Request For Termination, Form 943 - Request For Tax Clearance printable pdf download

Form Corp. 47 - Request For Termination, Form 943 - Request For Tax Clearance

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State of Missouri

Jason Kander, Secretary of State

Reset

Corporations Division

PO Box 778 / 600 W. Main St., Rm. 322

Jefferson City, MO 65102

Request for Termination

(Submit with filing fee of $25.00 and Certificate of Tax Clearance issued by the Missouri Department of Revenue)

The undersigned corporation, for the purpose of termination, hereby executes the following Request for Termination.

Article 1. Name of Corporation is

Charter #:

Article 2. On

, the corporation filed Articles of Dissolution with the Secretary of State.

month/day/year

Article 3. The corporation has disposed of all claims against it or filed against it pursuant to 351.478 and 351.482.

Article 4. All the remaining assets have been distributed among the corporation’s shareholders, in accordance with their respective

rights and interests.

Article 5. The effective date of this document is the date it is filed by the Secretary of State of Missouri unless a future date is otherwise

indicated:

(Date may not be more than 90 days after the filing date in this office.)

In Affirmation thereof, the facts stated above are true and correct.

(The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)

Authorized Signature

Printed Name

Title

Date

Name and address to return filed document:

Name:

Address:

City, State, and Zip Code:

Corp. 47 (09/2010)

Form Corp. 47 - Request For Termination, Form 943 - Request For Tax Clearance