Fillable CERTIFICATE OF WITHDRAWAL

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CERTIFICATE OF WITHDRAWAL

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CERTIFICATE OF WITHDRAWAL
TO: MUSCOGEE (CREEK) NATION SECRETARY OF THE NATION
P.O.
Box 580
Okmulgee, OK 74447
(918) 549-2607
The undersigned foreign limited liability company, for the purpose of surrendering its authority to do business
in the Muscogee (Creek) Nation and withdrawing therefrom, pursuant to Title 3, Section 2047, hereby
certifies:
1. The name of the foreign limited liability company is:____________________________________
and the state, territory or country under the laws of which the foreign limited liability company is
formed:_________________.
2. In the event the foreign limited liability company was registered in the Muscogee (Creek) Nation
under a fictitious name, the fictitious name is:
_____________________________________________________________________________________
3. The address to which process against the foreign limited liability company may be mailed is:
_____________________________________________________________________________________
4. The foreign limited liability company surrenders its authority to transact business in the Muscogee
(Creek) Nation and withdraws therefrom. The foreign limited liability company surrenders its certificate of
registration to transact business in the Muscogee (Creek) Nation.
5. The foreign limited liability company hereby revokes the authority of its registered agent in the
Muscogee (Creek) Nation to accept service of process and consents that process against the foreign limited
liability company in any action, suit or proceeding based upon any cause of action arising in the Muscogee
(Creek) Nation during the time the foreign limited liability company was authorized to transact business in
the Nation, may be served upon the Muscogee (Creek) Nation Secretary of the Nation in the manner provided
by law.
6. In the event the foreign limited liability company was dissolved, a copy of the certificate of
dissolution issued by the proper official of the state or jurisdiction of its incorporation MUST BE
ATTACHED HERETO.
FILING FEE: $100.00
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7. In the event the foreign limited liability company was dissolved by a court order or decree, a copy
of the order or decree certified by the court clerk or other official body, under the official seal of the court
or official body or clerk thereof MUST BE ATTACHED HERETO
.
MUST BE SIGNED BY A MANAGER, MEMBER, OR OTHER PERSON
Dated this _______day of ___________________, _______.
________________________________________________
Signature
________________________________________________
Type or print name and list title, if applicable
________________________________________________
Address
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CERTIFICATE OF WITHDRAWAL

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Completed 1 February 2022

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