Pennsylvania > Department Of State > Domestic Business Corporation
Statement Of Termination - Business Corporation Or Non-Profit Corporation DSCB 15-1902-5902 - Pennsylvania
| Statement Of Termination - Business Corporation Or Non-Profit Corporation Form. This is a Pennsylvania form and can be used in Domestic Business Corporation Department Of State . |
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PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Statement of Termination (15 Pa.C.S.) Business Corporation (§ 1902) Nonprofit Corporation (§ 5902) Document will be returned to the name and address you enter to the left. Name Address City State Zip Code Fee: $70 In compliance with the requirements of the applicable provisions (relating to statement of termination), the undersigned, desiring to terminate an amendment or plan that has not yet become effective, hereby states that: 1. Check one of the following: Set forth in full in Exhibit A, attached hereto and made a part hereof, is a copy of the filing to be hereby terminated. Articles of Amendment Articles of Consolidation Articles of Conversion Articles of Exchange (Business Only) Articles of Merger Articles of Division Statement with Respect to Shares (Business Only) 2. Check as appropriate: This statement has been executed by the corporation that filed the amendment. This statement has been executed by each corporation that is a party to the plan to be terminated. This statement has been executed by a corporation or corporations constituting less than all of the parties to the plan, as permitted by the plan to be terminated. 3. The amendment or plan has been terminated in accordance with the provisions thereof set forth therein. American LegalNet, Inc. www.FormsWorkFlow.com DSCB:15-1902/59022 IN TESTIMONY WHEREOF, the undersigned corporation(s) has (have) caused this Statement of Termination to be executed this day of . , Name of Corporation Signature Title Name of Corporation Signature Title American LegalNet, Inc. www.FormsWorkFlow.com Department of State Bureau of Corporations and Charitable Organizations P.O. Box 8722 Harrisburg, PA 17105-8722 (717) 787-1057 web site: www.dos.state.pa.us/corps Instructions for Completion of Form: A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit reproduction. The filing fee for this form is $70 made payable to the Commonwealth of Pennsylvania. Checks must contain a commercially pre-printed name and address. B. The following, in addition to the filing fee, shall accompany this form: two copies of a completed form DSCB:15134B (Docketing Statement-Changes) with respect to each association affected by the terminated filing. C. This form and all accompanying documents shall be mailed to the above stated address. American LegalNet, Inc. www.FormsWorkFlow.com
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