"Statement of Foreign Entity Withdrawal - Sample" - Colorado

Statement of Foreign Entity Withdrawal - Sample is a legal document that was released by the Colorado Secretary of State - a government authority operating within Colorado.

Form Details:

  • Released on June 28, 2011;
  • The latest edition currently provided by the Colorado Secretary of State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Colorado Secretary of State.

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Download "Statement of Foreign Entity Withdrawal - Sample" - Colorado

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Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Foreign Entity Withdrawal
filed pursuant to § 7-90-806 of the Colorado Revised Statutes (C.R.S)
1. The entity ID number, the entity name, and the true name, if different, are
Entity ID number
______________________________________________________
(Colorado Secretary of State ID number)
Entity name
______________________________________________________
True name
______________________________________________________.
(if different from the entity name)
2.
(Mark the applicable box and complete the statement. Caution: Mark only one box.)
The foreign entity will not maintain a registered agent in this state and service of process may be
addressed to the entity and mailed to the principal address pursuant to section 7-90-704 (2), C.R.S.
OR
The foreign entity will maintain a registered agent to accept service pursuant to section 7-90
204.5, C.R.S. Such registered agent’s name and address are:
Name
(if an individual)
______________________ ________________ ______________ ______
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
Street address
______________________________________________________
(Street name and number)
______________________________________________________
__________________________ CO
____________________
(City)
(State)
(Postal/Zip Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ______ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ __________________
(Province – if applicable)
(Country – if not US)
(The following statement is adopted by marking the box.)
The person appointed as registered agent above has consented to being so appointed.
WTDRW_AUTH
Page 1 of 3
Rev. 6/28/2011
Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Foreign Entity Withdrawal
filed pursuant to § 7-90-806 of the Colorado Revised Statutes (C.R.S)
1. The entity ID number, the entity name, and the true name, if different, are
Entity ID number
______________________________________________________
(Colorado Secretary of State ID number)
Entity name
______________________________________________________
True name
______________________________________________________.
(if different from the entity name)
2.
(Mark the applicable box and complete the statement. Caution: Mark only one box.)
The foreign entity will not maintain a registered agent in this state and service of process may be
addressed to the entity and mailed to the principal address pursuant to section 7-90-704 (2), C.R.S.
OR
The foreign entity will maintain a registered agent to accept service pursuant to section 7-90
204.5, C.R.S. Such registered agent’s name and address are:
Name
(if an individual)
______________________ ________________ ______________ ______
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
Street address
______________________________________________________
(Street name and number)
______________________________________________________
__________________________ CO
____________________
(City)
(State)
(Postal/Zip Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street name and number or Post Office Box information)
______________________________________________________
__________________________ ______ ____________________
(City)
(State)
(Postal/Zip Code)
_______________________ __________________
(Province – if applicable)
(Country – if not US)
(The following statement is adopted by marking the box.)
The person appointed as registered agent above has consented to being so appointed.
WTDRW_AUTH
Page 1 of 3
Rev. 6/28/2011
3. The principal office address of the entity’s principal office is
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ______ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ _________________
(Province – if applicable)
(Country)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ ______ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ _________________.
(Province – if applicable)
(Country)
4. The jurisdiction under the law of which the entity is formed is ____________________________________.
5.
(The following statement is adopted by marking the box.)
The entity will no longer transact business or conduct activities in Colorado and it relinquishes its
authority to transact business or conduct activities in Colorado.
6.
(The following statement is adopted by marking the box.)
All trade names the entity has on file in the records of the Secretary of State pursuant to Article 71 of
Title 7, C.R.S., and any assumed entity name pursuant to § 7-90-603, C.R.S., are withdrawn upon the
filing of this Statement of Foreign Entity Withdrawal.
7.
(If applicable, adopt the following statement by marking the box and include an attachment.)
This document contains additional information as provided by law.
8.
(Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has
significant legal consequences. Read instructions before entering a date.)
(If the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.)
The delayed effective date and, if applicable, time of this document is/are __________________________.
(mm/dd/yyyy hour:minute am/pm)
Notice:
Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that the document is the
individual's act and deed, or that the individual in good faith believes the document is the act and deed of the
person on whose behalf the individual is causing the document to be delivered for filing, taken in conformity
with the requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic
statutes, and that the individual in good faith believes the facts stated in the document are true and the
document complies with the requirements of that Part, the constituent documents, and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the Secretary of
State, whether or not such individual is named in the document as one who has caused it to be delivered.
WTDRW_AUTH
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Rev. 6/28/2011
9. The true name and mailing address of the individual causing the document to be delivered for filing are
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
______________________________________________________
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ ______ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ ________________.
(Province – if applicable)
(Country)
(If the following statement applies, adopt the statement by marking the box and include an attachment.)
This document contains the true name and mailing address of one or more additional individuals
causing the document to be delivered for filing.
Disclaimer:
This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice,
and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy
minimum legal requirements as of its revision date, compliance with applicable law, as the same may be
amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should
be addressed to the user’s legal, business or tax advisor(s).
WTDRW_AUTH
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Rev. 6/28/2011
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