Notice Of Intent To Dissolve - Georgia Secretary Of State

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Office Of The Secretary Of State
Corporations Division
Notice Of Intent To Dissolve
Brian P. Kemp
Secretary Of State
One
The Name Of The Corporation Is:
________________________________________________________________________
Two
The Date The Dissolution Was Authorized Was:
________________________________________________________________________
Three
(Choose Only One Of The Following Statements)
Dissolution Of The Corporation Was Duly Approved By The Shareholders In Accordance
With O.C.G.A. §14-2-1402.
Approval Of The Dissolution Was Not Required By The Shareholders.
Four
The undersigned does hereby certify that a request for publication of a notice of intent of to voluntarily
dissolve the corporation along with publication of fee of $40.00 will be forwarded to the official organ of the
county of the registered office as required by §14-2-1403.1(b).
IN WITNESS WHEREOF, the undersigned has executed this Notice Of Intent To Dissolve
On _________________________
_____________________ ___________________
(Date)
(Signature And Capacity in which signing)
Form CD 410

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