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Statement Of Cancellation Of Reacquired Shares (Domestic Corp) 104 - Rhode Island

Statement Of Cancellation Of Reacquired Shares (Domestic Corp) Form. This is a Rhode Island form and can be used in Business Corporation Secretary Of State .
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Filing Fee: $10.00 ID Number: ____________ STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 100 North Main Street Providence, Rhode Island 02903-1335 BUSINESS CORPORATION ____________ STATEMENT OF CANCELLATION OF REACQUIRED SHARES (To Be Filed In Duplicate Original) Pursuant to the provisions of Section 7-1.1-62 of the General Laws, 1956, as amended, the undersigned corporation submits the following statement of cancellation by resolution of its board of directors of shares of the corporation reacquired by it, other than redeemable shares redeemed or purchased: 1. The name of the corporation is 2. The number of reacquired shares of the corporation cancelled by resolution duly adopted by the board of directors of the corporation on , is , itemized as follows: Class Series Number of Shares 3. The aggregate number of issued shares of the corporation after giving effect to such cancellation is , itemized as follows: Class Series Number of Shares 4. Upon the filing of the statement of cancellation, the stated capital of the corporation shall be deemed to be reduced by that part of the stated capital which was, at the time of cancellation, represented by the shares so cancelled, and the shares so cancelled shall be restored to the status of authorized but unissued shares. Form No. 104 Revised: 01/99 <<<<<<<<<********>>>>>>>>>>>>> 25. As required by Section 7-1.1-62 of the General Laws, the corporation has paid all fees and franchise taxes. Date: Print Corporate Name By President or Vice President (check one) AND By Secretary or Assistant Secretary (check one)STATE OF COUNTY OF In , on this day of , personally appearedbefore me who, being by me first duly sworn, declared that he/sheis the of the corporation and that he/she signed the foregoing document assuch officer of the corporation, and that the statements herein contained are true. Notary Public My Commission Expires: <<<<<<<<<********>>>>>>>>>>>>> 3 STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 100 North Main Street Providence, Rhode Island 02903-1335 (401) 222-3040 INSTRUCTIONS FOR FILING STATEMENT OF CANCELLATION OF REAQUIRED SHARES Section 7-1.1-62 of the General Laws of Rhode Island, 1956, as amended1. A corporation may at any time, by resolution of its board of directors, cancel all or part of the shares of the corporation of any class reacquired by it, other than redeemable shares redeemed or purchased, and in such event a Statement of Cancellation of Reacquired Shares (Form No. 104) shall be filed, in duplicate original, with the Office of the Secretary of State, Corporations Division, at the above address. When the Statements are properly completed, signed and submitted with the correct filing fee, the file stamped duplicate original Statement of Cancellation of Reaquired Shares, shall be returned to the filer. 2. Upon the filing of the statement of cancellation, the stated capital of the corporation shall be deemed to be reduced by that part of the stated capital which was, at the time of the cancellation, represented by the shares so canceled, and the shares so canceled shall be restored to the status of authorized but unissued shares. 3. The Statement must be accompanied by a filing fee of $10.00, and payment should be made payable to the Rhode Island Secretary of State. 4. Upon the filing of the Statement of Cancellation of Reacquired Shares, the corporation must be in good standing and current with the filing of its annual reports and the maintenance of its registered agent and its registered office in this state. 5. As required by Section 7-1.1-62 of the General Laws, all fees and franchise taxes of the corporation must be paid upon the filing of the Statement of Cancellation of Reacquired Shares. 6. The Statement of Cancellation of Reacquired Shares must be signed, in duplicate original, by the corporations president or vice president and secretary or assistant secretary. A signature must appear on each line even if the same person holds both offices. The signature of one officer only must be notarized. Facsimile signatures will not be accepted. If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m.Instructions/Form 104 Revised: 01/99
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