Free 35228.PDF - Indiana

ARTICLES OF DISSOLUTION BY DIRECTORS OR INCORPORATORS OF A NONPROFIT CORPORATION
State Form 35228 (R5 / 1-03 ) / Co rporate Fo rm No. 10 7-A (1 -88) Appr ove d b y State Bo ard of Accou nts 1991

TODD ROKITA S ECRE TARY O F STATE CORPO RATIONS DIVISIO N 3 02 W. Wa sh ington St., Rm. E 018 India napoli s, IN 4 6204 Telep hone: (317) 232 -6576

INSTRUCTIONS: Use 8 1/2" x 11 " white paper for attachments. Present original and one (1) copy to address in upper right corner of this form. Please TYPE or PRINT. Please visit our office on the web at www.sos.in.gov.

FILING FEE: $30 .00 Indiana Code 23- 17-22- 1

The undersigned, desiring to effectuate the dissolution of _______________________________________________________________ (hereinafter referred to as the "Corporation"), existing pursuant to the provisions of the Indiana Nonprofit Corporation Law as amended, hereby certifies the following facts: 1. Date of Incorporation is: _______________________________________ ; 2. a. No membership in the Corporation has been issued; and / or b. The Corporation has not commenced business; 3. No debt of the Corporation remains unpaid; and 4. The majority of the incorporators or initial directors authorized the dissolution.

In Witness Whereof, the undersigned incorporator(s) or initial Director(s) of the Corporation hereby executes this certificate and verifies, subject to penalties of perjury, that the statements contained herein are true this ______________ day of ___________________________ , 20 ________ .
Signa ture Title (incorpora tor or Director )

Printed name