Free CORPFF7N19,156.WPD - Nebraska

CERTIFICATE OF WITHDRAWAL TO TRANSACT BUSINESS IN THE STATE OF NEBRASKA
NON-PROFIT CORPORATIONS
John A. Gale, Secretary of State Room 1301 State Capitol, P.O. Box 94608 Lincoln, NE 68509 http://www.sos.state.ne.us

Submit in Duplicate
(returned file stamped copy is your certificate of withdrawal)

_____________________________________________________________________
Name of Corporation

Incorporated under the laws of_____________________________desires to withdraw its authority to transact business in the State of Nebraska. This corporation is no longer transacting business in the State of Nebraska and surrenders its authority to transact business in the State of Nebraska. This corporation revokes the authority of its registered agent to accept servi ce of process on its behalf and consents that service of process in any proceeding during the time it was authorized to transact business in the state may be made on this corporation at the following address: Mailing Address at which process against corporation may be served: _____________________________________________________________________
Street Address City State Zip

DATED_______________________

________________________________
Signature

________________________________
Printed Name/Title NOTE: Every filing must be signed by the chairperson of the board of directors, the president, or one of the officers of the corporation. If the corporation has not yet been formed or directors have not yet been selected, the filing shall be signed by an incorporator. If the corporation is in the hands of a receiver, trustee, or other court appointed fiduciary, the filing shall be signed by that fiduciary.

FILING FEE: $10.00
Revised 12/19/2000 Neb. Rev. Stat. 21-19,156