Articles Of Reinstatement Form - Colorado Secretary Of State Page 2
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1
2
3Mailing address
______________________________________________________
(leave blank if same as street address)
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ _____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________
(Province – if applicable)
(Country – if not US)
6. The date of formation of the entity is ______________________ .
(mm/dd/yyyy)
7. The date of dissolution of the entity is (if known) ______________________.
(mm/dd/yyyy)
8.
(If the following statement applies, adopt the statement by marking the box and including an attachment.)
This document contains additional information as provided by law.
9.
(Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has significant legal
consequences. Read instructions before entering a date.)
(If the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.)
The delayed effective date and, if applicable, time of this document is/are ________________________.
(mm/dd/yyyy hour:minute am/pm)
10. The Colorado statute under which the entity existed immediately prior to its dissolution is
______________________________________________________.
11. All applicable conditions of CRS §7-90-1002 have been satisfied.
Notice:
Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that such document is such
individual's act and deed, or that such individual in good faith believes such document is the act and deed of the
person on whose behalf such individual is causing such document to be delivered for filing, taken in conformity with
the requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent documents and the organic
statutes, and that such individual in good faith believes the facts stated in such document are true and such document
complies with the requirements of that Part, the constituent documents, and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the Secretary of State,
whether or not such individual is identified in this document as one who has caused it to be delivered.
12. The true name and mailing
address of the individual causing
the document to be delivered for
filing are
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
______________________________________________________
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ ______________
(Province – if applicable)
(Country – if not US)
REINSTATE
Page 2 of 3
Rev. 1/6/2017
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