Michigan Foreign LLC Certificate of Withdrawal Form

For dissolving a limited liability company that is registered in the State of Michigan, the following form has to be completed and submitted along with a $10 fee.

Extracted Text for Proper Search

CSCL/CD-761 (Rev. 02/13)	
MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
CORPORATIONS, SECURITIES & COMMERCIAL LICENSING BUREAU	
Date Received	(FOR BUREAU USE ONLY)	
This document is effective on the date filed, unless a
subsequent effective date within 90 days after received
date is stated in the document.
EFFECTIVE DATE:	
Name
Address
City State ZIP Code
 	Document will be returned to the name and address you enter above.
If left blank, document will be returned to the registered office.	 	
APPLICATION FOR CERTIFICATE OF WITHDRAWAL	
For use by Foreign Limited Liability Companies
(Please read information and instructions on the last page)	
Pursuant to the provisions of Act 23, Public Acts of 1993, the undersigned execute the following Application:	
4.  The limited liability company is not transacting business or conducting affairs in Michigan.
1.  The name of the limited liability company is:
2.  The identification number assigned by the Bureau is:
3.  It is organized under the laws of
5.  The limited liability company hereby surrenders its authority to transact business or conduct affairs in Michigan.	
Signed this                       day of                                                                    ,
By	(Signature of authorized officer or agent)	
(Type or Print Name)	
6.  The limited liability revokes the authority of its resident agent to receive service of process in this state and consents that
     service of process in any action, suit, or proceeding based upon any cause of action arising in this state during the time the foreign
     limited liability company was authorized to transact business in this state may thereafter be made on the company by service upon
     the administrator.
7.  The address to which the administrator is to mail a copy of any process against this limited liability company is:	
(Name)	
(Street Address) (City)(ZIP Code)
(State)

CSCL/CD-761 (Rev. 02/13)
Preparer's Name
Business telephone number	
(            )	
Submit with check or money order by mail:
     Michigan Department of Licensing and Regulatory Affairs
     Corporations, Securities & Commercial Licensing Bureau
     Corporation Division
     P.O. Box 30054
     Lansing, MI  48909To submit in person:
               2501 Woodlake Circle
               Okemos, MI
               Telephone:  (517) 241-6470
Fees may be paid by check, money order,  VISA or
Mastercard when delivered in person to our office.
MICH-ELF (Michigan Electronic Filing System):
First Time Users:  Call (517) 241-6470, or visit our website at http://www.michigan.gov/corporations
Customer with MICH-ELF Filer Account:  Send document to (517) 636-6437INFORMATION AND INSTRUCTIONS
1.  The application for Certificate of Withdrawal cannot be filed until this form, or a comparable document is submitted.
2.  Submit one original of this document.  Upon filing, the document will be added to the records of the Corporations, Securities &
     Commercial Licensing Bureau.  The original will be returned to your registered office address unless you enter a different address in
     the box on the front of this document.
     Since this document will be maintained on electronic format, it is important that the filing be legible.  Documents with poor black and
     white contrast, or otherwise illegible, will be rejected.
LARA is an equal opportunity employer/program.  Auxiliary aids, services and other reasonable accommodations are available upon request to individuals
with disabilities.
3.  This application is to be used pursuant to section 1006 of Act 23, P.A. of 1993, for the purpose of withdrawing a limited liability
     company's Certificate of Authority to Transact Business in Michigan.  Upon filing of this Application the limited liability company
     surrenders its Certificate of Authority to Transact Business in this state.
 7.  NONREFUNDABLE FEE:  Make remittance payable to the State of Michigan.  Include limited liability company name and
      identification number on check or money order.........................................................................................................................$10.00 6.  The limited liability company must request a tax clearance within 60 days after submitting this certificate from the Michigan
     Department of Treasury, Tax Clearance Division, Lansing, MI  48922, (517) 636-5260. 5.  This Application must be signed by a person with authority to sign as provided in the laws of the jurisdiction of its organization. 4.  Item 2 - Enter the identification number assigned by the Bureau.  If this number is unknown, leave it blank.

Optional expedited service.
Expedited review and filing, if fileable, is available for all documents for profit corporations, limited
liability companies, limited partnerships and nonprofit corporations.
The nonrefundable expedited service fee is in addition to the regular fees applicable to the specific
document.
Please complete a separate CSCL/CD-272 form for expedited service for each document submitted
in person, by mail or MICH-ELF.
24-hour service - $50 for formation documents and applications for certificate of authority.
24-hour service - $100 for any document concerning an existing entity.
Same day service	
Same day - $100 for formation documents and applications for certificate of
authority.
Same day - $200 for any document concerning an existing entity.
Review completed on day of receipt.  Document and request for same day expedited
service must be received by 1 p.m. EST OR EDT.
Two hour - $500
Review completed within two hours on day of receipt.  Document and request for two hour
expedited service must be received by 3 p.m. EST OR EDT.
One hour - $1000
Review completed within one hour on day of receipt.  Document and request for 1 hour
expedited service must be received by 4 p.m. EST OR EDT.
First time MICH-ELF user requesting expedited service must obtain a MICH-ELF filer number prior
to submitting a document for expedited service.  CSCL/CD-901.
Changes to information on MICH-ELF user's account must be submitted before requesting
expedited service.  CSCL/CD-901.
Documents submitted by mail are delivered to a remote location for receipts processing and are
then forwarded to the Corporation Division for review.  Day of receipt for mailed expedited service
requests is the day the Corporation Division receives the request.	
Rev. 2/13