Application For Certificate Of Withdrawal For Foreign Corporation (For Profit)

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DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS
BUSINESS REGULATION ADMINISTRATION
CORPORATIONS DIVISION
Government
941 NORTH CAPITOL STREET, N.E.
WASHINGTON, D.C. 20002
of the
District of Columbia
APPLICATION FOR CERTIFICATE OF WITHDRAWAL
FOR FOREIGN CORPORATION (FOR PROFIT)
To:
DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS
BUSINESS REGULATION ADMINISTRATION
CORPORATIONS DIVISION
941 NORTH CAPITOL STREET, N.E.
WASHINGTON, D.C. 20002
Pursuant to the provisions of Section 113 of the District of Columbia Business Corporation Act, the
undersigned corporation hereby applies for a Certificate of Withdrawal from the District of Columbia and
for that purpose submits the following:
1. Name of Corporation
_____________________________________________________________________
2. Where Incorporated
_______________________________________________________________________
3. It is not transacting business in the District of Columbia and hereby surrenders its authority to transact
business in the District of Columbia.
4. It revokes the authority of its registered agent in the District of Columbia to accept service of process
and consents that service of process in any suit, action or proceeding based upon any cause of action
arising in the District of Columbia during the time the corporation was authorized to transact business in
the District of Columbia, may thereafter be made on the corporation by service thereof on the
Superintendent of Corporations, D.C.
5. The post office address to which the Superintendent of Corporations may mail a copy of any process
against the corporation that may be served on him is (include street and number)
_________________________________________________________________________________________.
Date: ______________________
Corporate Name __________________________________________________
(Corporate Seal)
By _______________________________________________
Its President or Vice President
FEES DUE: (MAKE CHECK PAYABLE TO THE D.C. TREASURER)
Filing Fee .......... $25.00

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