Office Of The Secretary Of State Corporations Division
Notice Of Intent To Dissolve
Karen Handel Secretary Of State
One
The Name Of The Corporation Is:
________________________________________________________________________ Two
The Date The Dissolution Was Authorized Was:
________________________________________________________________________ Three
(Choose Only One Of The Following Statements) Dissolution Of The Corporation Was Duly Approved By The Shareholders In Accordance With O.C.G.A. §14-2-1402. Approval Of The Dissolution Was Not Required By The Shareholders. Four The undersigned does hereby certify that a request for publication of a notice of intent of to voluntarily dissolve the corporation along with publication of fee of $40.00 will be forwarded to the official organ of the county of the registered office as required by §14-2-1403.1(b).
IN WITNESS WHEREOF, the undersigned has executed this Notice Of Intent To Dissolve
On _________________________ (Date)
_____________________ ___________________ (Signature And Capacity in which signing)
Form CD 410