Free corp 60-a - Missouri

State of Missouri
D WE S T ITE

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Robin Carnahan, Secretary of State
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The undersigned corporation, for the purpose of terminating, hereby executes the following Articles of Termination: 1. The name of corporation is 2. On
month/day/year

3. The corporation has disposed of all claims filed against it pursuant to Chapter 355.

4. All debts, obligations and liabilities of the corporation have been paid and discharged, or adequate provision has been made therefor. 5. The effective date of this document is the date it is filed by the Secretary of State of Missouri unless a future date is otherwise indicated:

In Affirmation thereof, the facts stated above are true and correct: (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)

Authorized signature of officer or chairman of the board

Name and address to return filed document: Name: Address: City, State, and Zip Code:
Corp. 60A (11/2008)

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Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102

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Articles of Termination For a Nonprofit Corporation
(Submit with filing fee of $10.00)

Charter #: the corporation filed Articles of Dissolution with the Secretary of State.

(Date may not be more than 90 days after the filing date in this Office)

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