BUSINESS REGISTRATION DIVISION P.O. BOX 29622
(Revised August 2017)
RALEIGH, NC 27626-0622
Form L-14
State of North Carolina
Department of the Secretary of State
APPLICATION FOR CERTIFICATE OF WITHDRAWAL
OF LIMITED LIABILITY COMPANY
Pursuant to §57D-7-20 of the General Statutes of North Carolina, the undersigned limited liability company hereby
applies to the Secretary of State for a Certificate of Withdrawal and for that purpose submits the following
statement.
1. The name of the foreign limited liability company is: .
2. The limited liability company is organized under the laws of: _.
3. The limited liability company is not transacting business in the State of North Carolina and surrenders its
authority to transact business in this State.
4. The limited liability company revokes the authority of its registered agent to accept service of process and
consents that servic
e of process in any action or proceeding based upon any cause of action arising in the State
of North Carolina, or arising out of business transacted in North Carolina, during the time the limited liabilit
y
company was authori
zed to transact business in North Carolina may hereafter be made on such limited liabilit
y
company by servic
e thereof on the Secretary of State.
5. The mailing address to which the Secretary of State may mail a copy of any process served on him/her pursuant
to the paragraph above is:
C/O
Number and Street: _
City:
State:
Zip
Code:
County:
6. The limited liability company hereby agrees to notify the Secretary of State of any changes in its mailing
address
.
7. This application will be effective upon filing, unless a date and/or time is specified: .
This the day of _, 20 .
Name of Limited Liability Company
Signature
Type or Print Name and Title
Notes:
1. Filing fee is $10. This application and one exact or conformed copy of this application must be filed with the Secretary of
State.
click to sign
signature
click to edit
![]()
