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Application For Withdrawal Of Certificate Of Authority CD 555 - Georgia

Application For Withdrawal Of Certificate Of Authority Form. This is a Georgia form and can be used in Corporation Secretary Of State .
 Fillable pdf Last Modified 8/21/2014
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CORPORATIONS DIVISION 237 Coliseum Drive Macon, GA 31217 (404) 656-2817 Application For Withdrawal of Certificate of Authority Brian P. Kemp Secretary Of State 1. Entity Type (check one only) Corporation Limited Liability Company Limited Partnership Limited Liability Partnership a) Entity Control No. 2. 3. 4. Entity Name Home State/Country (State/Country in which entity was formed) The entity selected in item 1 and named in item 2 no longer transacts business in Georgia and surrenders its certificate of authority. The entity revokes the authority of its registered agent to accept service of process on its behalf and appoints the Secretary of State of Georgia as its agent for service in any proceeding based on a cause of action that arose during the time it was authorized to transact business in Georgia. Any process served on the entity after withdrawal from Georgia may be mailed to the following address: 5. 6. 7. The withdrawing entity commits that it will notify the Secretary of State of any changes in the mailing address provided in item 6. 8. Signature Printed name of signer Title of person signing above (Check one only) Corporation: LLC: LP: LLP: Officer Receiver or Trustee Attorney-in-fact Member Manager Receiver or Trustee Attorney-in-fact General Partner Receiver or Trustee Attorney-in-fact General Partner Receiver or Trustee Attorney-in-fact Please mail completed application to the address provided at the top of this form. Certificate of withdrawal will be emailed to the address provided below. Form CD 555 (Rev. 1/2014) Email Address American LegalNet, Inc.
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