FILE ONE ORIGINAL
(Two if you want a filed
stamped copy returned to you)
FEE: $25.00
1. The
name of the company
to which
the Trade Name is registered to is:
__________________________________________
__________________________________________
and is
organized in the State of
:
__________________________________________
Date
the Trade Name was filed with
the WV Secretary of State’s Office:
__________________________________________
2. The
Trade Name being withdrawn
is:
__________________________________________
3. The
address of the principal office
of the
entity transacting business is:
__________________________________________
__________________________________________
4.
The
name, title, address
and
Name:
_____________________________________
signature
of the person having
authority to complete the
Title:
_____________________________________
application:
Street:
___________________________________________
City/State/Zip:
___________________________________________
5.
Signature
(See below
*
Important Legal Notice Regarding Signature
):
________________________________________________
_____________________________
Signature Date
*
Important Legal Notice Regarding Signature
:
Corporations/Voluntary Associations/Business Trusts/Unincorporated Nonprofit Associations/Limited
Partnerships -
Per
West Virginia Code §31D-1-129. Penalty for signing false document.
Any person who signs a document
he or she knows is false in any material respect and knows that the document is to be delivered to the Secretary of State for filing
is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one thousand dollars or confined in the
county or regional jail not more than one year, or both.
Limited Liability Companies/Limited Liability Partnerships
- Per
West Virginia Code §31B-2-209. Liability for false statement in filed record.
If a record authorized or required to be filed
under this chapter contains a false statement, one who suffers loss by reliance on the statement may recover damages for the loss
from a person who signed the record or caused another to sign it on the person's behalf and knew the statement to be false at the
time the record was signed.
CERTIFICATE OF WITHDRAWAL
OF TRADE NAME
Form NR-4
Rev. 11/2017
West Virginia Secretary of State
Business & Licensing Division
Tel: (304)558-8000
Fax: (304)558-8381
Website: www.wvsos.gov
CHOOSE ONE OF THE FOLLOWING PROCESSING SERVICES:
1 EXPEDITED SERVICE (24-hour, 2-hour and 1-hour; *Requires standard filing fee plus additional expedite fee, see below)
West Virginia Secretary of State
Business & Licensing Division
Tel: (304) 558-8000
Fax: (304) 558-8381
Website: www.wvsos.gov
Filing Submission Instructions - Business Division
SUBMIT THE COMPLETED APPLICATION WITH THE CUSTOMER ORDER REQUEST FORM TO ONE OF THE
OFFICES BELOW. CHOOSE EXPEDITED OR STANDARD PROCESSING SERVICE. IF NOT USING THE CUSTOMER
ORDER REQUEST FORM AND YOU ARE REQUESTING EXPEDITED SERVICE, YOU MUST INCLUDE THE WORD
"EXPEDITE" AND THE LEVEL OF EXPEDITED SERVICE BEING REQUESTED (24-HOUR, 2-HOUR OR 1-HOUR) IN
YOUR CORRESPONDENCE. BE SURE TO INCLUDE THE CORRECT ADDITIONAL EXPEDITED FEE. THIS FEE IS IN
ADDITION TO THE REGULAR FILING FEE (SEE FEES BELOW).
BUSINESS SERVICE CENTERS
Standard and Expedited Filings
Charleston Office
One-Stop Business Center
1615 Washington Street East
Charleston, WV 25311
Phone: (304) 558-8000
Fax: (304) 558-8381
Hours: Mon. - Fri. 8:30a - 5:00p EST
Clarksburg Office
North Central WV Business Center
200 West Main Street
Clarksburg, WV 26301
Phone: (304) 367-2775
Fax: (304) 627-2243
Hours: Mon. -Fri. 9:00a - 5:00p EST
IMPORTANT: READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING FORMS.
Please follow the instructions included with the application. Failure to include any of the required information on the form may
cause the filing to be rejected.
All forms may be downloaded from our web site www.wvsos.gov
.
Rev. 9/2018
*Fee
$ 25.00
$250.00
$500.00
Expedite Service
24-Hour
2-Hour
1-Hour
EXPEDITED SERVICE requests may be submitted by:
- E-mail to efilings@wvsos.gov
- Fax
- Walk in delivery
2 STANDARD PROCESSING (5-10 business days)
SUBMIT COMPLETED FILING TO ONE OF THE BUSINESS CENTERS BELOW:
INCLUDE PAYMENT:
Be sure to enclose the correct filing fee with your filing. If paying by credit card, be sure to include the e-Payment Authorization
form with your filing. Your filing will be rejected if the payment is not included or if the e-Payment Authorization form is not
included if paying by credit card.
Standard filing fees apply. STANDARD PROCESSING requests may be submitted by:
- E-mail to CorpFilings@wvsos.gov
- Fax
- Walk in delivery (drop off service only filed within 5-10 business days)
Martinsburg Office
Eastern Panhandle Business Center
229 E. Martin Street
Martinsburg, WV 25401
Phone: (304) 356-2654
Fax: (304) 260-4360
Hours: Mon. - Fri. 9:00a - 5:00p EST
READ CAREFULLY BEFORE SUBMITTING - Expedite service is NOT AVAILABLE for the following filings:
West Virginia Secretary of State
Business & Licensing Division
Tel: (304)558-8000
Fax: (304)558-8381
Website: www.wvsos.gov
Customer Order Request
SUBMIT THIS COMPLETED FORM WITH YOUR FILING.
Order Processing Requested*: * * * Expedite Processing Requires Additional Fees * * *
Standard Processing** 24-HOUR Expedite*** 2-HOUR Expedite 1-HOUR Expedite
Name of Entity:
Return filing to:
(Return Address)
Contact Name:
Phone:
Return Delivery Options: Email or Fax options do not receive a copy via mail; must be ordered separately.
Email to: Fax to:
Hold for Pick Up
UPS: Acct #Other (explain below):
(additional $500.00 fee included)(additional $25.00 fee included) (additional $250.00 fee included)
FedEx: Acct #Mail to Return Address above
Order Description (include items being ordered and fee breakdown):
* PLEASE NOTE: Original paperwork is kept by this office. Include a copy of the original filing if
you want a file stamped copy returned to you at no extra charge. Certified copy requests are an
additional $15 per certified copy being requested.
Total Amount:
Payment Method:
Cash (Do Not mail cash)
Pre-paid Acct #:
Credit Card (Must attach e-Payment Authorization request form including payment information.)Check/Money Order
*"Processing" indicates the filing will be completed and registered in the Secretary of State registration database.
**Standard Processing applications received by E-MAIL or FAX must include the e-Payment Authorization form with credit card information.
***NOTE: Orders filed in person through any Secretary of State office location requesting the filing be processed will be assessed a 24-HOUR
Expedite fee of $25.00 per order.
(Avg. processing turnaround
5-10 business days)
Rev. 9/2018
Attach signed pre-paid slip.
>> Tax Department filings including Sole Proprietorships, General Partnerships, and Associations
>> Dissolution or Withdrawal of Corporation, Voluntary Association or Business Trust
Email to: CorpFilings@wvsos.gov Email to: eFilings@wvsos.gov
24-hour, 2-hour and 1-hour
Expedite Service Guidelines
MAC WARNER
Secretary of State
State Capitol Building
Charleston, WV 25305
Phone: (304) 558-6000
Website: www.sos.wv.gov
IMPORTANT: To ensure expedited service, please mark “EXPEDITE” in a conspicuous place at
the top of the service request. Please indicate method of delivery.
24-HOUR EXPEDITE SERVICE
The Secretary of State offers a 24-hour expedite service on most business organization filings processed by this office. If
you choose to utilize this service, please enclose with your filing the additional expedite fee. Please note that this expedite
fee is in addition to the standard fee charged on each filing and/or order. You must mark the document with your “24-HOUR
EXPEDITE” request. If using a cover letter, note that you are requesting 24-hour expedited service, and include your
telephone number and return information. Each filing will be returned by U.S.P.S. regular mail unless other arrangements
are made. This office does not fax confirmation of a 24-hour expedite.
The fee for 24-hour handling is $25.00 in addition to the usual fee for service. Please consult our fee schedules for the
appropriate fee. If you require assistance, please contact this office.
Time Constraints: Under most circumstances, each filing submitted receives same day filing date and may be picked up in
the office by the end of the same business day. Filings to be mailed the next business day if received by 2:00 pm of receipt
date and no later than the 2nd business day if received after 2:00 pm. Expedite period begins when filing or service request
is received in this office in acceptable fileable form.
2-HOUR EXPEDITE SERVICE
The Secretary of State offers a 2-hour expedite service on most filings processed by this office. If you choose to utilize the
2-hour expedite service, please enclose with your filing an additional $250.00 per filing and/or order. Please note that this
expedite fee is in addition to the standard fee charged on each filing and/or order. Complete and submit the 2-hour
customer order instruction form. If not using our order form, state clearly in your cover letter that you are requesting 2-hour
expedited service and include your telephone number and return information. Attach the order form or cover sheet to the
top of your filing and submit to this office. Each filing will be returned by U.S.P.S. regular mail unless other arrangements
are made.
1-HOUR EXPEDITE SERVICE
The Secretary of State offers a 1-hour expedite service on most filings processed by this office. If you choose to utilize the
1-hour expedite service, please enclose with your filing an additional $500.00 per filing and/or order. Please note that this
expedite fee is in addition to the standard fee charged on each filing and/or order. Complete and submit the 1-hour
customer order instruction form. If not using our order form, state clearly in your cover letter that you are requesting 1-hour
expedited service and include your telephone number and return information. Attach the order form or cover sheet to the
top of your filing and submit to this office. Each filing will be returned by U.S.P.S. regular mail unless other arrangements
are made.
1-Hour and 2-Hour Time Constraints: Each filing submitted for either 1-hour or 2-hour expedite receives same day filing
date and will be acknowledged by fax or e-mail within expedite service time. Failure to indicate method of acknowledgement
(fax or e-mail) or to provide a correct fax number or e-mail address may prevent the Secretary of State from acknowledging
the filing of such documents. Filings may be picked up within the expedite service period. Filings to be mailed will be mailed
out no later than the next business day following receipt. Expedite period begins when filing or service request is received in
this office in fileable form.
The Secretary of State reserves the right to extend the expedite period in times of extreme
volume, staff shortages or equipment malfunction. These extensions are few and will rarely
extend more than a few hours.
WV Secretary of State Expedite Guidelines
Effective: 8-31-17
e-Payment Authorization
Credit Card Number:
Card Type:
Service Type:
Fax
MailE-mail
Visa
Mastercard Discover
American Express
Payment Information Storage Authorization
Year:
Entity Name:
Name as it appears on the account
Billing Address
City
State
Zip Code
Telephone
Ext.
I authorize the Secretary of State to store this payment information for future payment transactions processed by Secretary of State:
Authorized Signature
X
(required)
(optional)
Date
This document contains confidential financial information and will be properly shredded after payment
has been processed by this office. Electronic storage of payment information is only permitted by signed
authorization below which may be retracted at any time by written request by the authorized party.
Not to Exceed Amount:
USD $
Date
Month:
V Code*
* 3-digit number on back of VISA, MasterCard and Discover cards.
4-digit number on front right side of American Express card.
NOTICE: For security and verification purposes, all credit card payments must include the 3- or 4-digit CVV2 code (V Code) number
located on the credit card. Failure to include this code will result in the rejection of your filing or service request.
Rev. 11/2017
West Virginia Secretary of State
Business & Licensing Division
Tel: (304)558-8000
Fax: (304)558-8381
Website: www.wvsos.gov
USE BLACK INK ONLY - DO NOT HIGHLIGHT
Payment by Card
(card holder name and billing address required below)
Credit Card Expiration Date:
Amount to Charge Card:
USD $
Order Information (required)
Card Holder Information:
Payment Authorization
I authorize the Secretary of State to bill an amount not to exceed the following to be charged to the above listed account(s):
Authorized Signature
X
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