Statement Of Change Of Address By Withdrawn Corporation Foreign Corporation
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Statement Of Change Of Address By Withdrawn Corporation Foreign Corporation Form. This is a Pennsylvania form and can be use in Foreign Corporations - Business And Nonprofit Department Of State.
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Tags: Statement Of Change Of Address By Withdrawn Corporation Foreign Corporation, DSCB 15-4130, Pennsylvania Department Of State, Foreign Corporations - Business And Nonprofit
PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Statement of Change of Address by Withdrawn Corporation
Foreign Corporation
(15 Pa.C.S.)
Business Corporation (§ 4130)
Nonprofit Corporation (§ 6130)
Document will be returned to the
name and address you enter to
the left.
Name
Address
City
State
Zip Code
Fee: $70
In compliance with the requirements of the applicable provisions 15 Pa.C.S. (relating to corporations and unincorporated
associations), the undersigned foreign corporation, which was formerly a qualified foreign corporation, desiring to effect a change of
address to which process may be sent in any action upon any liability incurred before the filing of an application for termination of
authority, hereby states that:
1. The name of the withdrawn corporation is:
2. If this statement is filed by a successor in interest, complete the following:
Name of Successor
Capacity
3. The name of the jurisdiction under the laws of which the corporation filing this statement is incorporated is:
4. The former address of the withdrawn corporation as of record in the Department is:
Number and street
City
State
Zip
County
American LegalNet, Inc.
www.FormsWorkFlow.com
DSCB:15-4130/6130-2
5. The new address of the withdrawn corporation or its successor is:
Number and Street
City
State
Zip
County
IN TESTIMONY WHEREOF, the undersigned
corporation has caused this Statement of Change of
Address by Withdrawn Corporation to be signed by a duly
authorized officer thereof this
day of
,
.
Name of Corporation
Signature
Title
American LegalNet, Inc.
www.FormsWorkFlow.com
DSCB: 15-4130/6130
Department of State
Bureau of Corporations and Charitable Organizations
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
Web site: www.dos.state.pa.us/corps
Instructions for Completion of Form:
A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit
reproduction. The filing fee for this form is $70 made payable to the Department of State.
B. This form and all accompanying documents shall be mailed to the address stated above.
American LegalNet, Inc.
www.FormsWorkFlow.com
