Foreign Corporation (Business Or Non-Profit) Certificate Of Withdrawal - Alabama Secretary Of State Page 3

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FOREIGN CORPORATION (BUSINESS OR NON-PROFIT)
CERTIFICATE OF WITHDRAWAL 
 
Secretary of State Payment Option Sheet:
If you do not send an acknowledgement copy and a pre-addressed
postage paid envelope with the filing, you will not receive a credit card or prepaid account receipt from the Secretary of
State’s Office. Hold for pickup request – we do not offer a call for pick-up feature – acknowledgement copy will have the
receipt attached. Office personnel will not be able to search credit card or prepaid account transactions to help you
balance your accounts. Please do not use these options if you have problems collecting receipts from your filing agents.
The document of record will be stamped showing the receipt of the filing fee and expedite fee but no copy or convenience
fees.
Information MUST be typed or laser printed on a computer.
Entity Name:
Service Requested:
$100.00 Withdrawal filing fee
$100.00 Expedited Processing fee
*(Processed with 24 hours after receipt of filing)*
Hold at Front Desk for Pick-up for:
(Service providers who run couriers for pick-up – we do not have a call for pick-up service)
______ Check is attached - Please make one check payable for the total amount of the fees (i.e., $250 if you are
requesting expedited service) to the Alabama Secretary of State.
Charge fees to prepaid account: Account Number
and Account Name
Typed Name & Signature of Authorized Individual on Account
Credit Card Type:
(Visa, MC, Discover & AmEx)
Card Number:
Expiration Mo/Yr:
/
(MM/YY)
Card Holder Name:
Complete Billing Address:
Street or PO
City
State
Zip
Signature of Card Holder:
MUST be Signature of Card Holder
 
Page 3 of 4 
Foreign Corporation Withdrawal - 6/2017 
 
 
 
 

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