Certificate of Dissolution
for Non-Stock Corporation
Delaware Division of Corporations
401 Federal Street - Suite 4
Dover, DE 19901
Phone: 302-739-3073
Fax: 302-739-3812
Dear Sir or Madam:
Attached please find a copy of the Certificate of Dissolution to be filed in
accordance with Section 276 of the General Corporation Law of the State of Delaware.
The fee to file the Certificate is $204.00. If your document is more than 1 page, please
include $9.00 for each additional page. You will receive a stamped “Filed” copy of your
submitted document. Expedited services are available. Please contact our office
concerning these fees.
Please contact the Franchise Tax Section for taxes and reports that are due prior
to submitting the document for filing. Please make your check payable to “Delaware
Secretary of State”.
For the convenience of processing your order in a timely manner, please include a
cover letter with your name, address and telephone/fax number to enable us to contact
you if necessary. Please make sure you thoroughly complete all information requested on
this form. It is important that the execution be legible, we request that you print or type
your name under the signature line.
Thank you for choosing Delaware as your corporate home. Should you require
further assistance in this or any other matter, please don’t hesitate to call us at (302) 739-
3073.
Sincerely,
Department
of
State
Division of Corporations
encl.
rev. 07/04
STATE OF DELAWARE
CERTIFICATE OF DISSOLUTION OF
NON-STOCK CORPORATION
The corporation organized and existing under the General Corporation Law of the
State of Delaware.
DOES HEREBY CERTIFY AS FOLLOWS:
The dissolution of said
has been duly authorized in accordance with the provisions of Section 276(a)
of the General Corporation Law of the State of Delaware.
The date the dissolution was authorized is ________________________________
The following is a list of the names an