Form CFWN-1-1.0 "Application for Certificate of Withdrawal - Foreign Corporation" - Connecticut

What Is Form CFWN-1-1.0?

This is a legal form that was released by the Connecticut Secretary of the State - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2015;
  • The latest edition provided by the Connecticut Secretary of the State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CFWN-1-1.0 by clicking the link below or browse more documents and templates provided by the Connecticut Secretary of the State.

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Download Form CFWN-1-1.0 "Application for Certificate of Withdrawal - Foreign Corporation" - Connecticut

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SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
www.concord-sots.ct.gov
PHONE:
WEBSITE:
APPLICATION FOR CERTIFICATE OF WITHDRAWAL
FOREIGN CORPORATION
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING PARTY
:
FOR OFFICIAL USE ONLY:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
1. NAME OF CORPORATION IN ITS STATE/COUNTRY OF FORMATION:
2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH CORPORATION TRANSACTS BUSINESS IN
CONNECTICUT:
3. STATE OR COUNTRY OF INCORPORATION:
THE CORPORATION IS NOT TRANSACTING BUSINESS/CONDUCTING AFFAIRS IN CONNECTICUT AND SURRENDERS ITS AUTHORITY
TO TRANSACT FURTHER BUSINESS/CONDUCT AFFAIRS THEREIN.
THE CORPORATION REVOKES THE AUTHORITY OF ITS REGISTERED AGENT TO ACCEPT SERVICE OF PROCESS ON ITS BEHALF.
THE CORPORATION APPOINTS THE SECRETARY OF THE STATE AS ITS AGENT FOR SERVICE OF PROCESS AND CONSENTS TO
SERVICE OF PROCESS THEREON IN ANY ACTION, SUIT OR PROCEEDING BASED ON A CAUSE OF ACTION ARISING DURING THE
TIME IT WAS AUTHORIZED TO TRANSACT BUSINESS/CONDUCT AFFAIRS IN THIS STATE.
4. THE ADDRESS TO WHICH THE SECRETARY OF THE STATE MAY MAIL ANY PROCESS SERVED UPON HIM
IN ACCORDANCE WITH THE ABOVE STATED APPOINTMENT:
ADDRESS:
CITY:
STATE:
ZIP:
THE CORPORATION AGREES TO NOTIFY THE SECRETARY OF THE STATE IN THE FUTURE OF ANY CHANGES TO THE ABOVE STATED
ADDRESS.
FORM CFWN-1-1.0
PAGE 1 OF 2
Rev. 7/2015
SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
www.concord-sots.ct.gov
PHONE:
WEBSITE:
APPLICATION FOR CERTIFICATE OF WITHDRAWAL
FOREIGN CORPORATION
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING PARTY
:
FOR OFFICIAL USE ONLY:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
1. NAME OF CORPORATION IN ITS STATE/COUNTRY OF FORMATION:
2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH CORPORATION TRANSACTS BUSINESS IN
CONNECTICUT:
3. STATE OR COUNTRY OF INCORPORATION:
THE CORPORATION IS NOT TRANSACTING BUSINESS/CONDUCTING AFFAIRS IN CONNECTICUT AND SURRENDERS ITS AUTHORITY
TO TRANSACT FURTHER BUSINESS/CONDUCT AFFAIRS THEREIN.
THE CORPORATION REVOKES THE AUTHORITY OF ITS REGISTERED AGENT TO ACCEPT SERVICE OF PROCESS ON ITS BEHALF.
THE CORPORATION APPOINTS THE SECRETARY OF THE STATE AS ITS AGENT FOR SERVICE OF PROCESS AND CONSENTS TO
SERVICE OF PROCESS THEREON IN ANY ACTION, SUIT OR PROCEEDING BASED ON A CAUSE OF ACTION ARISING DURING THE
TIME IT WAS AUTHORIZED TO TRANSACT BUSINESS/CONDUCT AFFAIRS IN THIS STATE.
4. THE ADDRESS TO WHICH THE SECRETARY OF THE STATE MAY MAIL ANY PROCESS SERVED UPON HIM
IN ACCORDANCE WITH THE ABOVE STATED APPOINTMENT:
ADDRESS:
CITY:
STATE:
ZIP:
THE CORPORATION AGREES TO NOTIFY THE SECRETARY OF THE STATE IN THE FUTURE OF ANY CHANGES TO THE ABOVE STATED
ADDRESS.
FORM CFWN-1-1.0
PAGE 1 OF 2
Rev. 7/2015
5. EXECUTION:
I HEREBY DECLARE UNDER THE PENALTIES OF FALSE STATEMENT THAT THE STATEMENTS MADE IN THE
FOREGOING APPLICATION ARE TRUE.
, 20
DATED THIS
DAY OF
NAME OF SIGNATORY
CAPACITY/TITLE OF SIGNATORY
SIGNATURE
FORM CFWN-1-1.0
PAGE 2 OF 2
Rev. 7/2015
WITHDRAWAL OF FOREIGN CORPORATION (Stock or Nonstock Corporation)
COMPLETING THE APPLICATION FOR CERTIFICATE OF WITHDRAWAL
A foreign corporation authorized to transact business in Connecticut may withdraw its Certificate of Authority by filing an
Application for Certificate of Withdrawal. The withdrawing corporation must appoint the Secretary of the State as its agent for
service of process for matters relating to its activities in this state prior to withdrawal. It must further commit to notify the
Secretary of the State of any changes to the address to which it would have copies of legal process
sent following withdrawal.
Instructions Correspond With Numbered Entries On The Form
1. NAME OF CORPORATION IN STATE OR COUNTRY OF FORMATION: Please provide the complete name of the
corporation.
2. IF DIFFERENT FROM THE ABOVE, THE NAME UNDER WHICH THE CORPORATIONTRANSACTS BUSINESS IN
CONNECTICUT: Please provide the complete name which the corporation transacts business in this state if it is different
from the name under which it is incorporated.
3. STATE OR COUNTRY OF INCORPORATION: Please provide the corporation's state or country of incorporation.
4. THE MAILING ADDRESS TO WHICH THE SECRETARY OF THE STATE MAY MAIL ANY PROCESS SERVED UPON
HIM IN ACCORDANCE WITH THE ABOVE STATED APPOINTMENT: Please provide a complete address.
Note: It is the corporation's responsibility to file notices of any changes to this address following withdrawal.
5. EXECUTION: The document must be executed by an authorized official of the corporation. That person must print or type
their name, state the capacity under which they sign and provide a signature.
The execution constitutes a legal statement under the penalties of false statement that the information provided in
the document is true.
OFFICE OF THE SECRETARY OF THE STATE
MAILING ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
P.O. BOX 150470
HARTFORD, CT 06115-0470
DELIVERY ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
30 TRINITY STREET
HARTFORD, CT 06106
PHONE: 860-509-6003
WEBSITE:
www.concord-sots.ct.gov
FORM CFWN- 1-1.0
INSTRUCTIONS
DO NOT SCAN THIS PAGE
Rev. 7/2015
Page of 3