"Statement of Correction Revoking a Filed Document" - Colorado

Statement of Correction Revoking a Filed Document is a legal document that was released by the Colorado Secretary of State - a government authority operating within Colorado.

Form Details:

  • Released on October 18, 2017;
  • 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 fillable 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 Correction Revoking a Filed Document" - Colorado

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Document processing fee
If document is filed on paper
$150.00
If document is filed electronically
Not available
For more information or to print copies
of filed documents, visit www.sos.state.co.us.
Must be typewritten or machine printed.
ABOVE SPACE FOR OFFICE USE ONLY
Statement of Correction Revoking a Filed Document
§7- 90-305
filed pursuant to
of the Colorado Revised Statutes (C.R.S.)
1. For the entity, its ID number, entity name, and true name, if applicable, are
_________________________
ID number
(Colorado Secretary of State ID number)
Entity name
_________________________________________________________________________________.
True name
_________________________________________________________________________________.
_________________________.
2. The document number of the filed document being revoked is
3. Adopt one of the following statements by marking the box:
The filed document states a delayed effective date that is not yet effective and is revoked pursuant to section
7-90-304 (3), C.R.S.
OR
The filed document is revoked because it was delivered to the Secretary of State for filing in error.
(If applicable, adopt the following statement by marking the box and include an attachment.)
4.
This document contains additional information as provided by law.
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 such document is such
individual's act and deed, or that such individual in good faith believes such document is the act and deed of the person
on whose behalf such individual is causing such document to be delivered for filing, taken in conformity with the
requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent documents and the organic
statutes, and that such individual in good faith believes the facts stated in such document are true and such document
complies with the requirements of that Part, the constituent documents, and the organic statutes.
REVOKE
Page 1 of 2
Rev. 10/18/2017
Document processing fee
If document is filed on paper
$150.00
If document is filed electronically
Not available
For more information or to print copies
of filed documents, visit www.sos.state.co.us.
Must be typewritten or machine printed.
ABOVE SPACE FOR OFFICE USE ONLY
Statement of Correction Revoking a Filed Document
§7- 90-305
filed pursuant to
of the Colorado Revised Statutes (C.R.S.)
1. For the entity, its ID number, entity name, and true name, if applicable, are
_________________________
ID number
(Colorado Secretary of State ID number)
Entity name
_________________________________________________________________________________.
True name
_________________________________________________________________________________.
_________________________.
2. The document number of the filed document being revoked is
3. Adopt one of the following statements by marking the box:
The filed document states a delayed effective date that is not yet effective and is revoked pursuant to section
7-90-304 (3), C.R.S.
OR
The filed document is revoked because it was delivered to the Secretary of State for filing in error.
(If applicable, adopt the following statement by marking the box and include an attachment.)
4.
This document contains additional information as provided by law.
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 such document is such
individual's act and deed, or that such individual in good faith believes such document is the act and deed of the person
on whose behalf such individual is causing such document to be delivered for filing, taken in conformity with the
requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent documents and the organic
statutes, and that such individual in good faith believes the facts stated in such document are true and such document
complies with the requirements of that Part, the constituent documents, and the organic statutes.
REVOKE
Page 1 of 2
Rev. 10/18/2017
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 identified in this document as one who has caused it to be delivered.
5. The true name and mailing address
of the individual causing this 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).
REVOKE
Page 2 of 2
Rev. 10/18/2017
Business Information Survey (Optional)
For office use only
Submit with your form if you want to add, change, or remove survey information
Survey information can be added, changed, or removed when you file a form with our
office. The information on this survey is associated with the entity’s record- it does not
become a part of the document that you file with us.
This survey is voluntary. Any information that you enter will be available to the public. The
information is being gathered as required by law- see House Bill 13-1167 for information.
Entity information
ID number
Entity name
Choose one:
1. Remove all survey information from this entity’s record.
2. Add or update the survey information on this entity’s record as follows:
a) Gender
Male
Female
Choose not to answer / Remove this information
b) Veteran?
Yes
No
Choose not to answer / Remove this information
c) Person with a disability?
Yes
No
Choose not to answer / Remove this information
d) Race
African American
Latino
Anglo
Native American
Asian
Other
Choose not to answer / Remove this information
SurveyInfo
Page 1 of 2
Rev. 12/11/2013
Entity information continued
e) NAICS code(s)
Enter up to five. For more information, see the NAICS Association site at
www.naics.com/search.htm
.
Filer’s information
First
Middle
Last
Suffix
Address 1
Address 2
City
State
ZIP code
Province
Country
SurveyInfo
Page 2 of 2
Rev. 12/11/2013
Mail form with correct payment to:
Colorado Secretary of State
1700 Broadway Ste 200
Denver, CO 80290
Make checks payable to: Colorado Secretary of State
Include a separate check for each form submitted for filing.
If a document is rejected, this will allow us to return the check at
the time of rejection (if applicable). The document can be
corrected and resubmitted with the returned check.
Checks must be written for the exact amount
or the document may be rejected and returned.
Do not include this page with your filing.