Free Microsoft Word - cancel of registration - foreign stat trust.DOC - Connecticut

CANCELLATION OF REGISTRATION
MAILING ADDRESS: Commercial Recording Division Connecticut Secretary of the State P.O. Box 150470 Hartford, CT 06115-0470 860-509-6003 Space For Office Use Only

FOREIGN STATUTORY TRUST

DELIVERY ADDRESS: Commercial Recording Division Connecticut Secretary of the State 30 Trinity Street Hartford, CT 06106 860-509-6003

Filing Fee: $60.00

Make Checks Payable To "Secretary of the State"

1. NAME OF STATUTORY TRUST IN ITS STATE OR COUNTRY OF FORMATION:

2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH STATUTORY TRUST TRANSACTS BUSINESS IN CONNECTICUT:

3. STATE OR COUNTRY OF FORMATION:

The statutory trust is not transacting business in Connecticut and surrenders its authority to transact further business therein. The statutory trust further revokes the authority of its registered agent to accept service of process on its behalf. The statutory trust appoints the Secretary of the State as its agent for service of process and consents to service of process thereon in any action, suit or proceeding based on a cause of action arising during the time it was authorized to transact business in this state. 4. THE ADDRESS TO WHICH THE SECRETARY OF THE STATE MAY MAIL ANY PROCESS SERVED UPON HIM IN ACCORDANCE WITH THE ABOVE STATED APPOINTMENT: ___________________________________________
(Number and street or P.O. Box)

___________________________________________
(City, State and Zip Code)

5. EXECUTION
Dated this _____ day of _________, 20______.

Print or type name of signatory

Capacity of signatory

Signature
Rev. 08/24/2007