Free Form - Nevada

ROSS MILLER Secretary of State 204 North Carson Street, Suite 1 Carson City, Nevada 89701-4520 (775) 684 5708 Website: www.nvsos.gov

Dissolution of Corporation Sole
(PURSUANT TO NRS CHAPTER 84)

USE BLACK INK ONLY - DO NOT HIGHLIGHT

ABOVE SPACE IS FOR OFFICE USE ONLY

Certificate of Dissolution For a Nevada Corporation Sole (Pursuant to NRS Chapter 84) 1. Name of Corporation Sole:

2. The reason for the filing of the certificate of dissolution:

3. Any other information the representative filing the certificate determines:

4. Signature:

X
Signature Name of Subscriber or Successor

FILING FEE: $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.
Nevada Secretary of State NRS 84 Dissolution Revised: 3-13-09

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