Application For Certificate Of Withdrawal Of Foreign Profit Corporation printable pdf download

Prepare, sign, submit with an original signature and filing fee.

STATE OF MONTANA

This is the minimum information required

(This space for use by the Secretary of State only)

APPLICATION for CERTIFICATE

of WITHDRAWAL of FOREIGN PROFIT

CORPORATION

LINDA McCULLOCH

MAIL:

Secretary of State

P.O. Box 202801

Helena, MT 59620‐2801

PHONE:

(406) 444‐3665

FAX:

(406) 444‐3976

WEB SITE:

sos.mt.gov

Filing Fee: $15.00

24 Hour Priority Filing Add $20.00

1 Hour Expedite Filing Add $100.00

For the purpose of withdrawing from the State of Montana as a profit corporation (35‐1‐1037, MCA) the undersigned submits the

following statements of fact to the Secretary of State.

1. The name of the corporation is: __________________________________________________________________

2. It is incorporated under the laws of: _______________________________________________________________

3. It is not transacting business in Montana and it hereby surrenders its authority to transact business in Montana.

4. It revokes the authority of its registered agent in Montana to accept service of process on its behalf and appoints the secretary

of state as its agent for service of process in any proceeding based on a cause of action arising during the time it was authorized

to transact business in Montana.

5. Provide a mailing address to which the Secretary of State may mail a copy of any process against the corporation.

_______________________________________________________________________

Street

_____________________________________ ________________________ _______________________

City or town State Zip Code

6. It will notify the Secretary of State should any other changes be made in its mailing address.

7. If involved in a merger, the name of the surviving corporation is: _________________________________________________

and its state of jurisdiction is: ________________________________________

8. The mailing address of the surviving corporation is:

_______________________________________________________________________

Street

_____________________________________ ________________________ _______________________

City or town State Zip Code

9. A certificate from the Montana Department of Revenue stating that all taxes imposed pursuant to Title 15 have been paid must

be attached. You may contact them at (406) 444‐6900; PO Box 5805, Helena, MT 59620‐5805

The execution of any document required to be filed with the Secretary of State constitutes an affirmation, under

penalties of false swearing, by each person executing the document that the facts stated therein are true. (Section 35‐1‐

428, MCA)

___________________________________________ ___________________________ __________________________

Signature of Officer/Chair of Board Title Date

(Mo/Day/Yr)

46‐Certificate_of_Withdrawal_of_Foreign_Profit_Corporation.doc

Revised: 1/5/2009

Application For Certificate Of Withdrawal Of Foreign Profit Corporation

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