Form Merge_fgn - Statement Of Merger (Surviving Entity Is A Foreign Entity) - 2007
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ABOVE SPACE FOR OFFICE USE ONLY
Statement of Merger
(Surviving Entity is a Foreign Entity)
filed pursuant to
§ 7-90-203.7
and
§ 7-90-204.5
of the Colorado Revised Statutes (C.R.S.)
1. For each merging entity, its ID number (if applicable), entity name or true name, form of entity, jurisdiction
under the law of which it is formed, and principal address are
(Caution: At least one merging entity must be an entity formed under the laws of Colorado.)
ID Number
_________________________
(Colorado Secretary of State ID number)
Entity name or true name
______________________________________________________
Form of entity
______________________________________________________
Jurisdiction
______________________________________________________
Street
address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ ______________
(Province – if applicable)
(Country)
Mailing
address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ ______________.
(Province – if applicable)
(Country)
________________________________________________
ID Number
_________________________
(Colorado Secretary of State ID number)
Entity name or true name
______________________________________________________
Form of entity
______________________________________________________
MERGE_FGN
Page 1 of 5
Rev. 5/29/2007
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