Mississippi > Secretary Of State > Corporations > Limited Liability Company
Certificate Of Dissolution Or Cancellation F0103 - Mississippi
| Certificate Of Dissolution Or Cancellation Form. This is a Mississippi form and can be used in Limited Liability Company Corporations Secretary Of State . |
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11 F0103 Page 1 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 PHONE 601-359-1633 FAX 601-359-1499 Mississippi LLC Certificate of Dissolution The undersigned pursuant to Mississippi Code Ann. ยง79-29-801 (1972) amended (2010), hereby executes the following Certificate of Dissolution and sets forth: 1. Name of Limited Liability Company 2. The reason for filing the Certificate of Dissolution 3. The future effective date of dissolution 4. Any other information the members or managers determine to include By: Signature (Please keep writing within box) Printed Name Title Physical address P O Box City, State, Zip 5, Zip4 Make Check for $50.00 payable to SECRETARY OF STATE. Mail completed form with payment to SECRETARY OF STATE, PO BOX 136, JACKSON, MS 39205-0136. For assistance contact a customer service representative at (800) 256-3494. Visit our website at www.sos.ms.gov for forms and instructions. American LegalNet, Inc. www.FormsWorkFlow.com 11 F0103 Page 2 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 PHONE 601-359-1633 FAX 601-359-1499 Mississippi LLC Certificate of Dissolution By: Signature (Please keep writing within box) Printed Name Title Physical Address P.O. Box City, State, Zip5, Zip4 Make Check for $50.00 payable to SECRETARY OF STATE. Mail completed form with payment to SECRETARY OF STATE, PO BOX 136, JACKSON, MS 39205-0136. For assistance contact a customer service representative at (800) 256-3494. Visit our website at www.sos.ms.gov for forms and instructions. American LegalNet, Inc. www.FormsWorkFlow.com
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