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Nevada > Secretary Of State > Video Service Providers

Notice Of Termination To Existing Service Area - Nevada

Notice Of Termination To Existing Service Area Form. This is a Nevada form and can be used in Video Service Providers Secretary Of State .
 Fillable pdf Last Modified 6/27/2011
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ROSS MILLER Secretary of State 204 North Carson Street, Suite 1 Carson City, Nevada 89701-4520 (775) 684-5708 Website: Notice of Termination to Existing Service Area (PURSUANT TO NRS CHAPTER 711) USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY 1. Name of Certificate Holder: 2. The existing authorized service area designated to provide video service is being terminated as follows: (if additional space is needed, please attach an 8 1/2" x 11" plain sheet of paper and continue) 3. Signature of Certificate Holder: Name Title X Authorized Signature Filing Fee: $1,000.00 American LegalNet, Inc. Nevada Secretary of State CA Terminate Revised:: 4-28-09
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