SUBMIT ORIGINAL AND A COPY
TYPE OR PRINT LEGIBLY
Foreign Limited Liability Company
APPLICATION FOR CANCELLATION OF REGISTRATION
The undersigned limited liability company, in order to apply for a Certificate of Cancellation under the
New Mexico Limited Liability Company Act, submits the following statement:
1. The name of the limited liability company is (include NMPRC #): ______________________________
_____________________________________________________________________________________
2. It is organized under the laws of: _______________________________________________________
3. It is not transacting business in New Mexico. It surrenders its registration to transact business in New
Mexico. It confirms the authority of its registered agent for service of process in New Mexico. It
consents that service of process in any action, suit or proceeding based upon any cause of action arising
in New Mexico during the time the foreign limited liability company was registered to transact business
in New Mexico also may be made on such company by service upon the secretary of state.
4. The address to which a person may mail a copy of any process against the limited liability company is:
_____________________________________________________________________________________
_____________________________________________________________________________________
Dated: _____________________
______________________________________________
Name of Limited Liability Company
By___________________________________________
Signature of Authorized Person
Form FLLC-CAR
(revised 7/03)