Entity Number of Business Entity:
Business Entity Name:
*Please enter the business name under which the entity is being reinstated on the line above, however, if the entity is reinstating
under a different name, please list that name on the line below:
____________________________________________________________________________________________
(New Business Entity Name)
Submit with this application a completed Registration Information Change Form reflecting the
current
principal information (only needed if principals have changed). Enclose a Letter of Good Standing or
Letter of Tax Exemption from the Utah Tax Commission (applicable to Profit & Nonprofit Corporations).
Registered Agent Name and Address (Required):
Who/What is the Registered Agent (Individual or Business Entity or Commercial Registered Agent)?:
________________________________________________________________________________________
The address must be listed if you have a non-commercial registered agent. See instructions for further details.
Address of the Registered Agent: ___________________________________________________________
Utah Street Address Required, PO Boxes can be listed after the Street Address
City: State UT Zip:
I hereby remedy all prior defaults and file herewith a current Registration Information Change Form listing the current entity
principals together with the statutory reinstatement fee.
I hereby make application for reinstatement and request the Division of Corporations and Comm
ercial Code of the State of Utah
to issue a Certificate of Reinstatement and, under penalties of perjury, I declare that the foregoing statement is, to the best of my
knowledge and belief, true and correct.
I, _________________________________________________________________, hereby declare and affirm that
(Name)
I am a(n) ____________________________________ (Officer/Director, General Partner, or Member/Manager) of the business entity
listed above, which was involuntarily dissolved on _________________________ , 20 _______ , under
provisions of Utah law.
Signature (Required):
Under GRAMA {63G-2-201}, all registration information maintained by
the Division is classified as public record. For confidentiality purposes, you
may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
Optional Inclusion of Ownership Information: This information is not required.
Is this a female owned business? Yes No
Is this a minority owned business? Yes No If yes, please specify:
State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Application for Reinstatement
No
n
-
Refundable Processing Fee:[ ] Corp Profit $70.00 [ ] Corp Nonprofit $30.00 [ ] Limited Partnership $70.00
[ ] Limited Liability Company $70.00 [ ] Uniform LCA $22.00
Limited Liability Partnership $22.00
This form must be type written or computer generated.
Link to Registration Information Change Form
Link to Tax Commission Forms
This form cannot be hand written.
Link to Registration Information Change Form
Link to Tax Commission Forms
What is a commercial registered agent?
Sign here after printing form
Select/Type the race of the owner here
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
