Application For Certificate Of Withdrawal Form printable pdf download

NOTES

This application, which has been prescribed by the Commission pursuant to §§ 13.1-767 and

13.1-929 of the Code of Virginia, must be filed with the Commission before the Commission can

issue a certificate of withdrawal for a foreign corporation presently authorized to transact

business in Virginia. (A foreign corporation is one organized under the laws of a jurisdiction

other than Virginia.)

Until withdrawal has been completed (or the corporation's certificate of authority to transact

business is revoked for failure to file its annual report or pay its annual registration fee or

maintain a registered office and registered agent), the corporation will remain active on the

Commission's records and remain liable for the assessment and payment of annual registration

fees and the filing of annual reports, even though the corporation has been terminated in its

home jurisdiction, has stopped transacting business in Virginia or has wound up its affairs.

INSTRUCTIONS

The application must be in the English language, typewritten or printed in black, legible and

reproducible. The document must be presented on uniformly white, opaque paper, free of

visible watermarks and background logos.

You can download this form from our website at

The application must set forth the exact name of the corporation currently on file with the

Commission. Include the corporation’s designated name for use in Virginia if one was adopted.

The application for a certificate of withdrawal must be executed by the chairman or any vice-

chairman of the board of directors, the president, or any other of its officers authorized to act on

behalf of the corporation. Set forth the printed name and the corporate title below or next to the

signature. See §§ 13.1-604 and 13.1-804 of the Code of Virginia.

The person signing this application certifies that all statements and information set forth

therein are true, under penalty of law.

It is a Class 1 misdemeanor for any person to sign a document he knows is false in any

material respect with intent that the document be delivered to the Commission for filing.

The application cannot be filed unless the corporation has paid all fees, fines, penalties

and interest assessed against it by the Commission. See §§ 13.1-615 and 13.1-815 of the

Code of Virginia.

Submit the original, signed application to the Clerk of the State Corporation Commission, P.O.

Box 1197, Richmond, Virginia 23218-1197, (Street address: 1300 East Main Street, Tyler

Building, 1

Floor, Richmond, Virginia 23219), along with a check for the filing fee in the amount

of $10.00, payable to the State Corporation Commission. PLEASE DO NOT SEND CASH. If

you have any questions, please call (804) 371-9733 or toll-free in Virginia, 1-866-722-2551.

IF THE CERTIFICATE OF WITHDRAWAL IS EFFECTIVE PRIOR TO THE ANNUAL REPORT

DUE DATE (PRESCRIBED IN SUBSECTION C OF § 13.1-775 OR § 13.1-936 OF THE CODE

OF VIRGINIA) OF A GIVEN YEAR, THE CORPORATION'S ANNUAL REGISTRATION FEE

ASSESSMENT FOR THAT YEAR WILL BE CANCELED; OTHERWISE, IT MUST BE PAID.

See § 13.1-615 or § 13.1-815 of the Code of Virginia.

Application For Certificate Of Withdrawal Form