Free STATE OF SOUTH CAROLINA - South Carolina

STATE OF SOUTH CAROLINA SECRETARY OF STATE APPLICATION BY A FOREIGN NONPROFIT CORPORATION FOR A CERTIFICATE OF WITHDRAWAL FROM THE STATE OF SOUTH CAROLINA
TYPE OR PRINT CLEARLY IN BLACK INK

Pursuant to Section 33-31-1520 of the 1976 South Carolina Code of Laws, as amended, the undersigned nonprofit corporation hereby applies for a certificate of withdrawal authorizing it to withdraw from the State of South Carolina and to surrender its authority to transact business in the State of South Carolina. The undersigned hereby appoints the Secretary of State as agent for service of process and commits to notify the Secretary of State of any change in mailing address. 1. The name of the foreign nonprofit corporation as filed in South Carolina: _____________________________________________________________________________ 2. 3. The corporation is incorporated under the laws of:______________________________________
(State or Country)

The corporation received a certificate of authorization to transact business in South Carolina dated: _______________________________________
Month Day Year

4. 5.

The corporation is no longer transacting business in South Carolina. The corporation hereby surrenders its authority to transact business in the State of South Carolina. The corporation revokes the authority of its registered agent in South Carolina to accept service of process on its behalf and appoints the Secretary of State as its agent for service of process in any action, suit, or proceeding based upon any cause of action arising during the time it was authorized to do business in this State. The address to which the Secretary of State may mail a copy of any process against the Corporation that may be served on him is _____________________________________________________________________________ ______________________________________________________________________________

6.

7.

8.

Unless a delayed date is specified, this application shall be effective upon acceptance for filing by the Secretary of State (See Section 33-31-123(b) 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. 4. Two copies of this application, the original and either a duplicate original or a conformed copy, must be filed. If space on this form is insufficient, please attach additional sheets containing a reference to the appropriate paragraph in this form, or prepare this form by computer disk, which will allow additional space to be included on the form. This application must be accompanied by the filing fee of $10.00, payable to the Secretary of State. Return to: Secretary of State PO Box 11350 Columbia SC 29211

NP-APP BY A FRN NP FOR A CERTIFICATE OF WITHDRAWAL.doc

Form revised by South Carolina Secretary of State, January 2000