State of North Carolina
Department of the Secretary of State
APPLICATION FOR REINSTATEMENT FOLLOWING ADMINISTRATIVE
DISSOLUTION FOR NONPROFIT CORPORATION
Pursuant to §55A-14-22 of the North Carolina General Statutes, the corporation hereby submits this
Application for Reinstatement Following Administrative Dissolution:
1.
The name of the applicant corporation is:
2.
The effective date of the administrative dissolution of the applicant corporation was:
3.
The ground or grounds for administrative dissolution of the applicant corporation as stated in its
Certificate of Dissolution was or were:
4.
Complete either (a) or (b) as appropriate:
(a) The grounds stated above for the administrative dissolution of the applicant corporation did
not exist. (Insert brief explanation.)
(b) The grounds stated above for the administrative dissolution of the applicant corporation have
been eliminated. (Insert brief explanation.)
5.
Enclosed is a fee of $100.00 as required by §55A-1-22 of the North Carolina General Statutes.
This the __________ day of _________________, 20______.
_______________________________________
Name of Applicant of Corporation
_______________________________________
Signature
_______________________________________
Type or Print Name and Title
NOTES:
1. Filing fee for this Application for Reinstatement is $100.00, payable by check made to the order of the
Secretary of State.
2. This Application and one exact or conformed copy must be filed with the Secretary of State.
(Revised May 1998)
(Form N-08)
CORPORATIONS DIVISION
300 N. SALISBURY STREET
RALEIGH, NC 27603-5909