Form Dc-9 - Articles Of Merger - 2001 Page 2
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1
2FORM DC-9
1/2001
We certify under the penalties of Section 415-136, Hawaii Revised Statutes, that we have read the above statements and that
the same are true and correct.
Signed this ____________day of ___________________________________, __________
Parent or Surviving corporation:
_____________________________________________________________________________________
(Type/Print Corporate Name)
_______________________________________________________
_________________________________________________________
(Type/Print Name & Title)
(Type/Print Name & Title)
_______________________________________________________
_________________________________________________________
(Signature of Officer)
(Signature of Officer)
Instructions: Articles of Merger must be typewritten or printed in black ink, and must be legible. The articles must be signed
by two individuals who are officers of the parent or surviving corporation. All signatures must be in black ink. Submit original
articles together with the appropriate fee.
Line 1. State the full name of the parent or surviving corporation and its state of incorporation.
Line 2. State the full name of the subsidiary or merging corporation and its state of incorporation.
Line 5. Give the month, day and year that a copy of the Plan of Merger was mailed to the shareholders of the subsidiary
corporation.
Line 6. Complete the information for the number of outstanding shares of each class of the subsidiary corporation and the
number of shares owned by the surviving corporation.
Line 7. Check whether the merger is effective on the date and time of filing the Articles of Merger with the Department of
Commerce and Consumer Affairs, State of Hawaii, or effective on a future date. If a future date is selected, state the
effective date and time, which cannot be more than 30 days after the filing of the Articles of Merger.
Filing Fees: Filing fee ($100.00) is not refundable. Make checks payable to DEPARTMENT OF COMMERCE AND
CONSUMER AFFAIRS. Dishonored Check ($15 fee plus interest charge).
NOTICE: THIS MATERIAL CAN BE MADE AVAILABLE FOR INDIVIDUALS WITH SPECIAL NEEDS. PLEASE CALL THE
DIVISION SECRETARY, BUSINESS REGISTRATION DIVISION, DCCA, AT 586-2744, TO SUBMIT YOUR REQUEST.
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