Free APPLICATION FOR WITHDRAWAL - Arizona

PHOENIX OFFICE
1300 West Washington Phoenix, Arizona 85007-2929 Phone: (602) 542-3026 Toll Free (AZ only): 1-800-345-5819

TUCSON OFFICE
400 West Congress, Suite #221 Tucson, Arizona 85701-1347 Phone: (520) 628-6560 Toll Free (AZ only): 1-800-345-5819

www.azcc.gov

ARIZONA CORPORATION COMMISSION CORPORATIONS DIVISION

www.azcc.gov

GENERAL FILING INSTRUCTIONS FOREIGN NON PROFIT CORPORATION APPLICATION FOR WITHDRAWAL BY MEMBERS OR INITIAL DIRECTORS Pursuant to A.R.S. §10-11521
This form is to be used only for foreign corporations that have not conducted business, and that if they have done so, they need to complete form CF0025.

A.FILING FEE: $25.00 (EXPEDITED SERVICE AVAILABLE FOR AN ADDITIONAL $35.00) [A.R.S. §10-122.(A)(16) AND (F)(2)] B. THERE IS NO REQUIREMENT FOR EITHER PUBLICATION OR A TAX CLEARANCE FORM FROM THE ARIZONA DEPARTMENT OF REVENUE. C. THE DOCUMENT SHALL BE TYPEWRITTEN OR PRINTED AND SHALL BE LEGIBLE AND CAPABLE OF MICROFILM. [A.R.S. §10-3120.(D).]
DOCUMENT AND ANY EXHIBITS TO THE DOCUMENT SHALL BE IN THE ENGLISH LANGUAGE OR ACCOMPANIED BY AN ENGLISH TRANSLATION CERTIFIED AS ACCURATE BY OR ON BEHALF OF THE PERSON CAUSING THE DOCUMENT TO BE DELIVERED FOR FILING. [A.R.S. §10-3120.(E).]

D. THE

E. THE WITHDRAWAL MUST BE EXECUTED PURSUANT TO A.R.S. §10-3120.(F). F. THIS FORM MAY BE USED BY A CORPORATION SUBJECT TO THE FOLLOWING REQUIREMENTS: THE CORPORATION HAS NOT COMMENCED BUSINESS IN THIS STATE.

For further information, please contact the Corporation's Division Customer Service Information line at 602-542-3026 or toll free, Arizona Resident only (800) 345-5819.

CF: 0025B Rev 09/2008

Arizona Corporation Commission Corporations Division

FOREIGN NON PROFIT APPLICATION FOR WITHDRAWAL BY MEMBERS OR INITIAL DIRECTORS Pursuant to A.R.S. §10-11521
This form is to be used only for foreign corporations that have not conducted business, and that if they have done so, they need to complete form CF0025.

The undersigned, for the purpose of surrendering its authority to conduct affairs in the state of Arizona pursuant to Title 10, Section §10-11521, does hereby execute this application. 1. The name of the foreign corporation in this state: _________________________________________________________________________ 2. 3. 4. 5. 6. The name of the state or country of its incorporation: _______________________________ The corporation has not commenced conducting affairs in the State of Arizona. No debt of the corporation acquired in the State of Arizona remains unpaid. A majority of the directors or members authorized the withdrawal. The foreign corporation revokes the authority of its statutory agent to accept service on its behalf and appoints the commission as its agent for service of process in any proceeding based on a cause of action arising during the time it was authorized to conduct affairs in this state. A mailing address to which the commission may mail a copy of any process served on the commission pursuant to its appointment as the foreign corporation's agent for service of process, is as follows: Address: _______________________________________________________________ City _____________________________ , State: __________________, Zip: ________ 8. The corporation will notify the Arizona Corporation Commission in the future of any change in the foreign corporation's mailing address.

7.

Dated this __________day of ________________________, __________ .

Executed by: (duly authorized officer) ____________________________
[Print Name/Title]

Signature: _____________________________
CF: 0025B Rev 09/2008 Arizona Corporation Commission Corporations Division