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Application For Certificate Of Withdrawal By Reason Of Merger Consolidation Or Conversion Form. This is a North Carolina form and can be use in Business Entity Secretary Of State.
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Tags: Application For Certificate Of Withdrawal By Reason Of Merger Consolidation Or Conversion, BE-09, North Carolina Secretary Of State, Business Entity
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
State of North Carolina :
Index No.
Department of the Secretary of State
:
Calendar No.
:
JUDICIAL
Plaintiff(s)
APPLICATION FOR CERTIFICATE OF WITHDRAWAL SUBPOENA
BY -against- OF MERGER, CONSOLIDATION
REASON
:
OR CONVERSION
:
Pursuant to §55-15-21, §55A-15-21, § 57C-7-12, § 59-91 or § 59-909, of the General Statutes of North Carolina as applicable, the
undersigned entity, as the surviving or resulting entity in a statutory merger, consolidation or conversion hereby applies to the
:
Secretary of State for a Certificate of Withdrawal for the foreign entity(ies) authorized to transact business or conduct affairs in the
State of North Carolina named below, whose separate existence has ceased as a result of the merger, consolidation or conversion, and
Defendant(s)
:
............. ....... .......
for that purpose submits the. following .statement: . . . . . . . . . . . . . . . . . . . . . . . . .
1.
The name of the surviving or resulting entity is:_______________________________________________________________
a.
The surviving or resulting entity is incorporated,YORK or created under the laws of:
THE PEOPLE OF THE STATE OF NEW formed
__________________________________________________________________________________________________
b.
The type of entity of the surviving or resulting entity:________________________________________________________
___________________________________________________________________________________________________
TO
2.
The surviving or resulting entity is not authorized to transact business or conduct affairs in the State of North Carolina.
3.
The name of each foreign entity authorized to transact business in North Carolina (and its fictitious name used in the State of
North Carolina, WE COMMAND YOU, that allis:_____________________________________________________________
if different from its official name) business and excuses being laid aside, you and each of you attend before
________________________________________________________________________________________________________
,
the Honorable
at the
Court
GREETINGS:
County of
located at
a.
Theroom of the state, or country under whose law each such entity was incorporated, formed or created and at any recessed
in name
on the
day of
, 20
, at
o'clock in the
noon,
is:__________________________________________________________________________________________________
or adjourned date, to testify and give evidence as a witness in this action on the part of the
____________________________________________________________________________________________________
b.
The type of entity of each foreign entity:____________________________________________________________________
____________________________________________________________________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the partyor resulting entity herebysubpoenathat service offor a maximum penalty of $50 and all damages sustained as a
4. The surviving on whose behalf this consents was issued process based on any cause of action arising in the State of North
result arising failure to comply.
Carolina, or of yourout of business transacted or affairs conducted in this State during the time each foreign entity was authorized
to transact business or conduct affairs in this State may thereafter be made by service thereof on the Secretary of State.
5.
Witness, Honorable
Court in
County,
, one of the Justices of the
The mailing address to which the Secretary of State may mail a copy of any process served pursuant to the paragraph above is:
day of
, 20
C/O_____________________________________________________________________________________________________
Address_________________________________________________________________________________________________
(Attorney must sign above and type name below)
City, State, Zip Code_______________________________________________________________________________________
6.
The surviving or resulting entity hereby agrees to file a statement of any subsequent change in its mailing address with the
Attorney(s) for
Secretary of State.
7.
Attached hereto is a copy of the articles of merger, consolidation or conversion or a certificate reciting the facts of the merger,
consolidation or conversion duly authenticated by the Secretary of State or other official having custody of records of such
entities in the state or country under the laws of which such merger was effected. and P.O. Address
Office
CORPORATIONS DIVISION
(Revised January 2002)
P.O. BOX 29622
Telephone No.:
Facsimile No.:
RALEIGH, NC 27626-0622
E-Mail Address:
(Form BE-09)
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
8. This application will be effective upon filing, unless a date and/or time is specified here:____________
:
This the ________day of ________________ , 20____
Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
____________________________________
:
Name of Surviving/Resulting Entity
-against-
:
____________________________________
Signature
:
____________________________________
Defendant(s) or Print Name and Title
:
Type
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
NOTES
1. Filing fee is $10. This application must be filed with the Secretary of State. The application must be accompanied by a copy of the
articles of merger, consolidation or conversion or a certificate reciting the factsOfficemerger, consolidation or conversion duly
of the and P.O. Address
authenticated by the Secretary of State or other official having custody of the records of such entities in the state or country under the
laws of which the foreign entity was organized, incorporated or created.
2. This form is to be used only if the surviving corporation is not authorized to transact business or conduct affairs in North Carolina.
CORPORATIONS DIVISION
(Revised January 2002)
P.O. BOX 29622
Telephone No.:
Facsimile No.:
RALEIGH, NC 27626-0622
E-Mail Address:
(Form BE-09)
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
