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STATE OF SOUTH CAROLINA SECRETARY OF STATE APPLICATION FOR REINSTATEMENT OF A NONPROFIT CORPORATION DISSOLVED BY ADMINISTRATIVE ACTION
TYPE OR PRINT CLEARLY IN BLACK INK

Pursuant to Section 33-31-1422 of the 1976 South Carolina Code of Laws, as amended, the undersigned hereby applies to the Secretary of State for reinstatement of a nonprofit corporation dissolved by administrative action and for that purpose, submits the following information: 1. The name of the corporation at the time of dissolution was And the effective date of the administrative dissolution was ____________________. 2. Complete either "a" or "b", whichever is applicable a. [ ] Grounds for administrative dissolution did not exist. b. [ ] The grounds for administrative dissolution, which were

have now been eliminated. 3. The corporation's name satisfies the requirements of Section 33-31-401 of the 1976 South Carolina Code of Laws, as amended.

Date
Name of Corporation

Signature

Type or Print Name and Office

FILING INSTRUCTIONS
1. 2. 3. Two copies of this form, one of which can be either a duplicate original or a conformed copy, must be filed. Filing fee (Payable to the Secretary of State at the time of filing this application) - $25.00 THIS APPLICATION MUST BE FILED WITHIN TWO YEARS AFTER THE EFFECTIVE DATE OF THE CORPORATION'S DISSOLUTION BY ADMINISTRATIVE ACTION AND MUST BE ACCOMPANIED BY A CERTIFICATE FROM THE SOUTH CAROLINA DEPARTMENT OF REVENUE RECITING THAT ALL STATE TAXES OWED BY THE CORPORATION HAVE BEEN PAID. Return to: Secretary of State P.O. Box 11350 Columbia, SC 29211

NP-APP FOR REINSTATEMENT OF A NP DISSOLVED.doc

Form Approved by South Carolina Secretary of State, January 2000