Free Filing Fee - Rhode Island


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STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Office of the Secretary of State Corporations Division 148 W. River Street Providence, Rhode Island 02904-2615 (401) 222-3040

INSTRUCTIONS FOR FILING STATEMENT OF CANCELLATION OF REDEEMABLE SHARES
Section 7-1.2-601(e) of the General Laws of Rhode Island, 1956, as amended The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant statutory provision. This form and the information provided are not substitutes for the advice and services of an attorney and/or tax specialist. 1. When redeemable shares of a corporation are redeemed or purchased by the corporation, the redemption or purchase shall effect a cancellation of the shares, and a Statement of Cancellation of Redeemable Shares (Form No. 103) shall be filed with the Office of the Secretary of State, Corporations Division, at the above address. 2. Upon the filing of the Statement of Cancellation of Redeemable Shares, the shares shall be restored to the status of authorized but unissued shares, unless the articles of incorporation provide that the shares, when redeemed or purchased, shall not be reissued, in which case the filing of the Statement of Cancellation shall constitute an amendment to the articles of incorporation and shall reduce the number of shares of the class so canceled which the corporation is authorized to issue by the number of shares so canceled. 3. The Statement must be accompanied by a filing fee of $10.00, and payment should be made payable to the Rhode Island Secretary of State. 4. Upon the filing of the Statement, the corporation must be in good standing and current with the filing of its annual reports and the maintenance of its registered agent and its registered office in this state. 5. As required by Section 7-1.2-601(e) of the General Laws, all fees and franchise taxes of the corporation must be paid upon the filing of the Statement of Cancellation of Redeemable Shares. 6. The Statement of Cancellation of Redeemable Shares must be signed by an authorized officer of the corporation. If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m.

Instructions/Form 103 Revised: 12/05

Filing Fee: $10.00

ID Number:

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Office of the Secretary of State Corporations Division 148 W. River Street Providence, Rhode Island 02904-2615

BUSINESS CORPORATION ____________ STATEMENT OF CANCELLATION OF REDEEMABLE SHARES
Pursuant to the provisions of Section 7-1.2-601(e) of the General Laws of Rhode Island, 1956, as amended, the undersigned corporation submits the following statement of cancellation by redemption or purchase of redeemable shares of the corporation: 1. 2. The name of the corporation is The number of redeemable shares of the corporation cancelled through redemption or purchase is itemized as follows: Class Series Number of Shares ,

3.

The aggregate number of issued shares of the corporation after giving effect to such cancellation is itemized as follows: Class Series Number of Shares

,

4. If the articles of incorporation provide that the cancelled shares shall not be reissued, the number of shares the corporation has authority to issue after giving effect to such cancellation is , itemized as follows: (If not applicable, so state.) Class Series Number of Shares

Form No. 103 Revised: 12/05

5. As required by Section 7-1.2-601(e) of the General Laws, the corporation has paid all fees and franchise taxes. 6. This Statement of Cancellation of Redeemable Shares was duly adopted by the Board of Directors of the corporation on 7. The Statement of Cancellation of Redeemable Shares shall become effective upon the filing of this statement unless a specified date is provided which shall be no later than the 90th day after the date of this filing Under penalty of perjury, I declare and affirm that I have examined this Statement of Cancellation of Redeemable Shares, including any accompanying attachments, and that all statements contained herein are true and correct. Date: Signature of Authorized Officer of the Corporation Type or Print Name of Authorized Officer