Statement Curing Delinquency

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Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement Curing Delinquency
filed pursuant to §7-90-904 of the Colorado Revised Statutes (C.R.S)
1. For the delinquent entity, its ID number, entity name and jurisdiction of formation are
ID number
_________________________
(Colorado Secretary of State ID number)
Entity name
______________________________________________________
Jurisdiction where formed
______________________________________________________.
2. By providing the information required herein, this statement corrects all grounds for delinquency cited by
the secretary of state.
3. The registered agent name and registered agent address of the registered agent are
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name).
The person appointed as registered agent above has consented to being so appointed.
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________
(City)
(State)
(Zip Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(Zip Code)
(If the following statement applies, adopt the statement by marking the box.)
The mailing address in the records of the Secretary of State is no longer different than the street
address and is no longer required.
4. The principal office address of the entity’s principal office is
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________
(Province – if applicable)
(Country – if not US)
CURE_DLQ
Page 1 of 2
Rev. 8/08/2012

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