Foreignapplicationwithdrawal Feb 2018
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
1. The Name and
Business ID of the corporation is:
Name (Note: This must be the exact corporate name as registered.) Business ID
2. The name of the state or other jurisdiction under whose laws it is incorporated:
3. The corporation is no longer transacting business in this state and it surrenders its authority to transact business in this
state.
4. The cor
poration revokes the authority of its registered agent to accept service on its behalf.
5. The address of the corporation’s principal office (this is the address of the executive offices of the company):
Street Address
City State
ZIP+4
Mailing Address if different from street address
City State
ZIP+4
Email Address (Optional)
The appli
cation must be signed by an authorized officer of the corporation.
No pers
on may execute this report knowing it is false in any material respect. Any violation may be subject to a civil and/or
criminal penalty (SDCL 47-1A-129; 22-39-36).
Dated
Signature of an authorized person
Email
(Optional) Printed Name
Title
APPLICATION FOR
CERTIFICATE OF WITHDRAWAL
FOREIGN BUSINESS CORPORATION
SDCL 47-1A-1520
FILING FEE: $10
Make check payable to SECRETARY OF STATE
click to sign
signature
click to edit
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