COMMONWEALTH OF KENTUCKY ALISON LUNDERGAN GRIMES, SECRETARY OF STATE __________________________________________________________________________________________________________________________ Division of Business Filings Business Filings PO Box 718 Frankfort, KY 40602 (502) 564-3490 www.sos.ky.gov Articles of Dissolution Nonprofit Corporation NPD Please note: Filing this form with the Office of the Secretary of State does not ensure the dissolution of the business entity is complete. Filers are encouraged to seek the advice of a professional prior to filing Articles of Dissolution. Pursuant to the provisions of KRS 14A and KRS 273.313, the undersigned corporation executes the following articles of dissolution: Article I: The name of the non-profit corporation is ___________________________________________________________. (The name must be identical to the name on record with the Secretary of State.) Article II: The resolution to dissolve was adopted at a meeting of the (board of directors or at least 2/3 majority of members) held on _____________________________. A quorum was present at such meeting, and said resolution received a vote of the majority of the (directors or members). Article III: This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date or the delayed effective cannot be prior to the date the application is filed. The date and/or time is _________________. (Delayed effective date and/or time) Article IV: All debts, obligations and liabilities of the corporation have been paid and discharged or adequate provision has been made therefor. Article V: No plan of distribution was adopted. Article VI: There is no remaining property and assets of the corporation. Article VII: There are no suits pending against the corporation in any court. I declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct. _________________________________________ _______________________ ____________ __________ Signature of Officer or Chairman of the Board Printed Name Title Date (01/12) American LegalNet, Inc. www.FormsWorkFlow.com FILING INSTRUCTIONS ARTICLES OF DISSOLUTION NAME The non-profit corporation name provided on the articles of dissolution must read exactly as stated in the most recent articles. This can be found using the organization search tool located on the Secretary of State website at www.sos.ky.gov. REQUIREMENTS FOR DOCUMENTS TO BE PROPERLY FILED The articles of dissolution must be an officer or chairman of the board. PLAN OF DISTRIBUTION If you need to file a plan of distribution, you should not use this form, but rather submit a drafted executed copy of the articles of dissolution. PRINCIPAL OFFICE ADDRESS The principal office is the office (in or out of this state) so designated in writing with the Office of the Secretary of State where the principal designated office of the business entity is located. This address is where all correspondence from the Office of the Secretary of State (See Document Delivery) will be mailed. EFFECTIVE DATE AND TIME The document will be effective on the date and time of filing, unless a delayed effective date and/or time is specified. The effective date or the delayed effective date cannot be prior to the date the application is filed. A delayed effective date may not be later than the 90th day after the date of filing. ADDITIONAL ARTICLES OF DISSOLUTION OR NEED TO MODIFY THE EXISTING FORM If this form does not comply with the articles of dissolution that you wish to file, please disregard this form and send a drafted executed copy of the articles of dissolution according to KRS 273.313 to the address below. DOCUMENT DELIVERY A file stamped postcard will be sent to the principal office address. If the applicant wishes for the document to be sent to an alternate address other than the principal office, a request must be submitted in writing affirming that request. Alternate address requests must be submitted with each document filed with the Office of the Secretary of State. NUMBER OF COPIES If filing via mail or in person, one exact or conformed copy of the documents with the filing fee must be submitted to the address below. To make a copy of the filing for delivery to the local county clerk's office, visit www.sos.ky.gov and print a copy from the organization search tool. FILING FEE The filing fee for Articles of Dissolution is $5.00. Your check should be made payable to the "Kentucky State Treasurer." MAILING ADDRESS Alison Lundergan Grimes Secretary of State P. O. Box 718 Frankfort, KY 40602-0718 OFFICE LOCATION Room 154, Capitol Building 700 Capital Avenue Frankfort, KY 40601 Hours of Operation: 8:00 AM-4:30 PM ET CONTACT INFORMATION If you have any questions or need additional forms, please feel free to visit our website at www.sos.ky.gov or call (502) 564-3490. (01/12) American LegalNet, Inc. www.FormsWorkFlow.com