Withdrawal Of Foreign Registration Statement {211}

211 WITHDRAWAL OF FOREIGN REGISTRATION STATEMENT Title 30, Chapter 21, Idaho Code Filing fee: $20 Complete and submit the application in duplicate. 1. The name of the entity is: The name which it used in Idaho is: 2. Jurisdicton of formation: 3. The address to which service of process may be made against the entity (after the withdrawal): (Address) a. The entity is not transacting business in the State of Idaho, and withdraws its registration to do business in this state. b. The entity revokes the authority of its registered agent in the State of Idaho to accept service of process on its behalf in this state. c. The entity agrees to notify the Idaho Secretary of State of any change to the address in item 3. Typed Name: Signature: Capacity: Rev. 07/2015 American LegalNet, Inc. www.FormsWorkFlow.com Secretary of State use only INSTRUCTIONS If the document is incorrect, provide contact information where can you be reached for corrections: Phone Number Email address nate an ending to comply with Idaho Code, enter such name in the second portion of this section (the name which it used in Idaho). Line 2 - Enter the domestic jurisdiction. Line 3 - Enter the address to which future service of process may be made. The application must be signed by a governor of the entity. Please specify the name of the signer by typing his/her name below the signature and indicate in what capacity he/she signs. Enclose the appropriate fee (make checks payable to the Idaho Secretary of State): enter the customer account number in the indicated space. Mail or deliver to: PO Box 83720 Boise ID 83720-0080 American LegalNet, Inc. www.FormsWorkFlow.com 211 WITHDRAWAL OF FOREIGN REGISTRATION STATEMENT Title 30, Chapter 21, Idaho Code Filing fee: $20 Complete and submit the application in duplicate. 1. The name of the entity is: The name which it used in Idaho is: 2. Jurisdicton of formation: 3. The address to which service of process may be made against the entity (after the withdrawal): (Address) a. The entity is not transacting business in the State of Idaho, and withdraws its registration to do business in this state. b. The entity revokes the authority of its registered agent in the State of Idaho to accept service of process on its behalf in this state. c. The entity agrees to notify the Idaho Secretary of State of any change to the address in item 3. Typed Name: Signature: Capacity: Rev. 08/2015 American LegalNet, Inc. www.FormsWorkFlow.com Secretary of State use only