Voluntary Statement Of Foreign Merger Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Voluntary Statement Of Foreign Merger Form. This is a Oregon form and can be use in Business Registry Secretary Of State.
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Voluntary Statement of Foreign Merger
Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - http://www.FilingInOregon.com - Phone: (503) 986-2200
SURVIVOR
REGISTRY NUMBER:
(IF APPLICABLE)
In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record.
We must release this information to all parties upon request and it will be posted on our website.
For office use only
Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary.
1)
NAME OF SURVIVING ENTITY:
2)
OREGON REGISTRY NUMBER:
(IF APPLICABLE)
3)
DOMICILE STATE OF SURVIVING ENTITY:
4)
NEW NAME OF SURVIVING ENTITY:
(IF CHANGED)
5)
NAME OF NON-SURVIVING ENTITY:
6)
OREGON REGISTRY NUMBER:
(IF APPLICABLE)
7)
8)
9)
DOMICILE STATE OF NON-SURVIVING ENTITY:
A CERTIFICATE OF MERGER IS ATTACHED (OPTIONAL)
EXECUTION:
Must be signed by an officer or director for a corporation, a member or manager for a limited liability company, or a general partner for a limited
partnership.
Signature:
CONTACT NAME: (To resolve questions with this filing.)
PHONE NUMBER: (Include area code.)
Printed Name:
Title:
FEES
Foreign Acquiring Entity Required Processing Fee
Confirmation Copy (Optional) $5
$275
Processing Fees are nonrefundable. Please make check payable to “Corporation Division.”
Voluntary Statement of Foreign Merger (10/10)
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