For Office Use Only
Corporate Filings 312 Rosa L. Parks Avenue 6th Floor, William R. Snodgrass Tower Nashville, TN 37243
WRITTEN CONSENT TO DISSOLUTION
We, the undersigned, being all of the shareholders or members entitled to vote, hereby give our written consent to the dissolution of
(Corporate Name)
a corporation organized and existing under the laws of the State of Tennessee on the following terms and conditions (Insert here any terms and conditions which are desired and are in accordance with law):
Date: _____________________ Signature: _____________________ Name: _____________________
(Typed or Printed)
Signer's Capacity: _____________________
SS-4255 (Rev. 4/01)
No Filing Fee
RDA 1678