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Application For Certificate Of Withdrawal L-14 - North Carolina

Application For Certificate Of Withdrawal Form. This is a North Carolina form and can be used in Limited Liability Company Secretary Of State .
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State of North Carolina Department of the Secretary of State APPLICATION FOR CERTIFICATE OF WITHDRAWAL OF LIMITED LIABILITY COMPANY Pursuant to 57C-7-11 of the General Statutes of North Carolina, the undersigned limited liability company hereby applies to the Secretary of State for a Certificate of Withdrawal and for that purpose submits the following statement. 1. The name of the foreign limited liability company is:_______________________________________ 2. The limited liability company is formed under the laws of:___________________________________ 3. The limited liability company is not transacting business in the State of North Carolina and surrenders its authority to transact business in this State. 4. The limited liability company revokes the authority of its registered agent to accept service of process and consents that service of process in any action or proceeding based upon any cause of action arising in the State of North Carolina, or arising out of business transacted in North Carolina, during the time the limited liability company was authorized to transact business in North Carolina may hereafter be made on such limited liability company by service thereof on the Secretary of State. 5. The mailing address to which the Secretary of State may mail a copy of any process served on him pursuant to the paragraph above is: C/O______________________________________________________________________________ Address___________________________________________________________________________ City, State, Zip Code_________________________________________________________________ 6. The limited liability company will file a statement of any subsequent change in its mailing address with the North Carolina Secretary of State. 7. This application will be effective upon filing, unless a date and/or time is specified:________________ This the _______ day of _____________________ , 20 ____ ___________________________________ Name of Limited Liability Company ____________________________________ Signature ____________________________________ Type or Print Name and Title Notes: 1. Filing fee is $10. This application must be filed with the Secretary of State. CORPORATIONS DIVISION P.O. BOX 29622 RALEIGH, NC 27626-0622 (Revised January, 2002) (Form L-14) <<<<<<<<<********>>>>>>>>>>>>> 2 Instructions for Filing APPLICATION FOR CERTIFICATE OF WITHDRAWAL LIMITED LIABILITY COMPANY Item 1 Enter the complete name of the limited liability company exactly as it appears on the Certificate of Authority. Item 2 Enter the state or country of formation. Item 3 See form. Item 4 See form. Item 5 Enter the complete address to which the Secretary of State may send a copy of any process served pursuant to the paragraph above. Item 6 See form. Item 7 The document will be effective on the date and at the time of filing, unless a delayed date or an effective time (on the day of filing) is specified. If a delayed effective date is specified without a time, the document will be effective at 11:59:59 pm on the day specified. If a delayed effective date is specified with a time, the document will be effective th on the day and at the time specified. A delayed effective date may be specified up to and including the 90 day after the day of filing. Date and Execution Enter the date the document was executed. In the blanks provided enter: The name of the limited liability company as it appears in item 1. The signature of the representative of the limited liability company executing the document. The name and title of the above-signed representative. CORPORATIONS DIVISION P.O. BOX 29622 RALEIGH, NC 27626-0622 (Revised January, 2002) (Form L-14)
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