Fillable Ohio I Notication of Dissolution or Surrender (State of Ohio)

Fill Online, Printable, Fillable, Blank Ohio I Notication of Dissolution or Surrender (State of Ohio) Form

Use Fill to complete blank online STATE OF OHIO (OH) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Ohio I Notication of Dissolution or Surrender (State of Ohio)

On average this form takes 17 minutes to complete

The Ohio I Notication of Dissolution or Surrender (State of Ohio) form is 2 pages long and contains:

  • 0 signatures
  • 9 check-boxes
  • 63 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Ohio

BROWSE STATE OF OHIO (OH) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Ohio
I
Depa~ment of
Taxation
D
D
D D
D
D
D
D
D
D
D
D
D
D
D
D
D
D
D
D5
Rev. 10/20
Tax Release Unit
P.O. Box 182382
Columbus, OH 43218-2382
Notification of Dissolution or Surrender
All corporations seeking a dissolution, surrender, consolidation, merger or conversion must submit this form to the Ohio
Department of Taxation at least 30 days prior to the date the corporation intends to file with the Ohio Secretary of State.
A Certificate of Tax Clearance will not be issued until all taxes/fees administered by the Tax Commissioner are fi led and
paid. Review the notification of dissolution or surrender instructions before completing.
1. Name of corporation
(as recorded with the Ohio Secretary of State)
DBA (if applicable)
Address
FEIN Ohio charter/entity no.
Date qualified in Ohio Incorporation date State of incorporation
2. Select corporation/entity type:
Domestic For-Profit Domestic Nonprofit LLC
Foreign For-Profit Foreign Nonprofit Domestic/Foreign Nonprofi t Agricultural Cooperative
3. Select dissolution/surrender method: Certificate of Tax Clearance Affidavit
(Domestic for-profit corporations must select Certificate of Tax Clearance)
4. Select reason for dissolution/surrender: Consolidation Conversion Dissolution/Surrender
Merger
5. Date Ohio business activity ceased or will cease (mm/dd/yyyy):
Ending date of last payroll subject to Ohio withholding (mm/dd/yyyy):
Date corporation intends to dissolve its Ohio charter/license (mm/dd/yyyy):
6. Type of business activity/product sold:
NAICS code:
7. Name, address, telephone and fax number of person to whom inquiries may be made. If this is a
representative, please include a Declaration of Tax Representative (Ohio TBOR 1):
8. Select each tax applicable to this corporation and provide information requested. See section 3 of the instructions for
information on how to close certain accounts with the Ohio Department of Taxation:
Tax Type Ohio Account No. Date Final Return Filed
Commercial activity tax
Consumer use tax/direct pay permit
Corporation franchise tax
Employer withholding tax
Excise/energy taxes
(motor fuel, alcohol, tobacco, public utility)
Financial institutions tax (also see #9 on page 2)
- 1 -
Reset Form
D
D
D
D
D5
Rev. 10/20
Sales tax/sellers use tax
School district employer withholding tax
Wireless 9-1-1- fee
(Include an additional sheet if necessary)
9. If you fi le the financial institution tax as part of a group, provide the name and FIT account number of the reporting member:
10. Name, address, FEIN and Ohio charter/license number of the entity (if any) that is continuing the business activities of
the converting/merging corporation:
11. List any matters pending with the Ohio Department of Taxation, such as petitions for reassessment, requests for refunds,
etc. and list any appeals to the Board of Tax Appeals:
12. Identify the person and mailing address where the Certificate of Tax Clearance should be sent (if different from response
#7). If this is a representative, include an Ohio TBOR 1:
13. List each officer’s and director’s name, address and SSN (include additional list if necessary):
Name and Title Home Address SSN
14. I declare and affirm, under penalties provided by law, that this application has been examined by me and the state-
ments contained therein are true to the best of my information, knowledge and belief. By my signature, as an officer of
the corporation or as the person who will execute the dissolution/surrender, I (i) acknowledge that all of my tax accounts with
the Ohio Department of Taxation will be closed as of the date provided in section 5 (the latter of last day of business or last day
of payroll); (ii) acknowledge that the dissolution/surrender does not relieve the corporation for payment of all taxes/fees
administered by and required to be paid to the Tax Commissioner; and (iii) acknowledge, if the corporation is a domestic
nonprofit corporation organized under Ohio Revised Code (R.C.) chapter 1702 or a domestic nonprofit agricultural cooperative
organized under R.C. chapter 1729, the applicability of R.C. sections 1702.55 and 1729.25, respectively.
Signature
Date
Name
Title
- 2 -
Online Notice Response Service:
tax.ohio.gov - Contact Us
-or- gateway.ohio.gov
eFax: (206) 984-0378
Phone: (855) 995-4422
Email: dissolution@tax.state.oh.us
Mail:
Ohio Department of Taxation
Tax Release Unit
P
.O. Box 182382
Columbus, OH 43218-2382
To submit this application, please use one of the following options:
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Ohio I Notication of Dissolution or Surrender (State of Ohio)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 11 March 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document