ROSS MILLER Secretary of State 204 North Carson Street, Suite 1 Carson City, Nevada 89701-4520 (775) 684 5708 Website: www.nvsos.gov
Foreign Withdrawal
(PURSUANT TO NRS 80.200)
USE BLACK INK ONLY - DO NOT HIGHLIGHT
ABOVE SPACE IS FOR OFFICE USE ONLY
Notice of Withdrawal For a Foreign Corporation Qualified to do Business in Nevada (Pursuant to NRS 80.200) 1. Name of foreign corporation:
2. Modified name (if foreign qualification filed pursuant to 80.025)
3. State or country of incorporation: 4. The corporation hereby notifies the Secretary of State of Nevada of its intention to surrender its right to transact business and withdraw from the State of Nevada. 5. By authority of a resolution of the board of directors of said corporation, this notice of withdrawal is executed by the proper officers thereof. 6. Signature of authorized officer: (if more than one signature, attach a plain 8 1/2" x 11" sheet of paper
with additional signatures)
X
Signature of Officer
Title
Date
FILING FEE: For-Profit Corporations: $75.00 Non-Profit Corporations: $50.00
IMPORTANT: Failure to include any of the above information and submit with the proper fees may cause this filing to be rejected.
This form must be accompanied by appropriate fees.
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Nevada Secretary of State Foreign Withdrawal Revised: 3-12-09