Montana Foreign Non Profit Dissolution Form

In the case of a foreign non-profit entity that is registered in the State of Missouri wanting to terminate the registered legal entity in the state, the following form has to be completed and submitted.

Extracted Text for Proper Search

sos.mt.gov/Business/Forms	 	66-Foreign_Nonprofit_Corporation_Certificate_of_Withdrawal.doc	 	Revised: 	11/14	/2011	 	
 	
 	
STATE OF MONTANA	 	
 
CERTIFICATE 	of 	WITHDRAWAL 	 	
of 	FOREIGN NONPROFIT CORPORATION	 	
APPLICATION	 	
35	-2-831, MCA	 	
 
MAIL:	 	 	LINDA McCULLOCH	 	
Secretary of State	 	
P.O. Box 202801	 	
Helena, MT 59620	-2801	 	
PH	ONE:	  	(406)	 444	-3665	 	
FAX:	 	(406)	 444	-3976	 	
WEB SITE:	 	sos.	mt.gov	 	
 	
Prepare, sign	 & submit 	with 	the proper	 filing	 fee.	 	 This is the minimum information required.	 	
(This space for use by the Secretary of State only)	 	
 
 
 
 
 
 
 
 
 
 
 	
 	
 	
            	     Required Filing Fee:  $15.00	  	
             	 24 Hour 	Priority 	Handling check box &	 Add	 $20.00	 	
 	 	 	 	 	 	 	 	       	      	1 Hour Expedite 	Handling check box &	 Add $100.00	 	
 
For the purpose of withdrawing from the State of Montana as a 	nonpro	fit corporation the undersigned submits the following 	
statements of fact to the Secretary of State:	 	
 
 
1. 	The 	exact 	name of the corporation:	 _________________________________________________________________________	 	
 
2. 	It is	 incorporated under the laws of:	 _________________________________________________________________________	 	
 
3. 	It is not transacting business in Montana and it hereby surrenders its authority to transact business and conduct affairs in 
Montana.	 	
 
4. 	It revokes the authority of its register	ed agent in Montana to accept service of process	 on its behalf	 and 	appoints the secretary 	
of state as its agent for service of process in any proceeding based on a cause of action arising during the time it was auth	orized 	
to do business in this state	 	
 
5. 	Provide a 	business 	mailing address to which the Secretary of State may mail a copy of any process against the corporation 	
served on him:	 	
Business mailing address: 	________	______________________	____________________________________________________	 	
 
City/town:	 ____________________________________________  	State:	 ____	________________  Zip Code:	 _______________	 	
 
6. 	It will notify the Secretary of State should any other changes be made in its mailing address.	 	
 
7. 	The reason for filing this withdrawal	 (this informa	tion is optional):_	____________________________________________	____	 	
 
 	______________________________________________________	______	____________________________________________	 	
 
8. 	The execution of any document required to be filed with the Secretary of Stat	e constitutes an affirmation, under penalties of 	
false swearing, by each person executing the document that the facts stated therein are true	 (35	-1-428, MCA	). 	
 
 	___________________________	_________	____________________              	__________________________________________	 	
 	Signature	 of officer or chairman of board	 	 	 	 	  Title	 	
 
 	___________________________________________	______	______        	 	__________________________________________	 	
 	Printe	d name of individual signing	 	 	 	 	 	Date	 	
 
 
 
 	Daytime Contact: Phone _____________________ Email _________	____________________________	________________	____

updated	: 10/25	/2011	 	
 	
 	
GENERAL 	INSTRUCTIONS	 	
 
Please type or print clearly when filling out this form.	 	
 
ALL INFORMATION PUBLIC	 	
 
All information provided, including names and addresses of 	the 	principal	s of the 	entity,	 will be made 	
available on the Secretary of State’s web site or	 upon request.	 	
 
LEGAL AND ACCOUNTING IMPLICATIONS	 	
 
There are important legal and accounting implications with respect to this 	entity’s	 action	s. Suitable legal 	
and accounting advice should be secured before submission. The Secretary of State’s office 	sugges	ts that 	
such advice be sought prior to filling out forms to be sure that you understand the terms and procedures.	 	
 
FORM PROCESSING TI	ME 	
 
Please be advised that the Business Services 	Division	 of the Montana Secretary of State will process your 	
business docu	ments within 10 working days of receipt. 	 	
 	
 	During this period if it	 is determined that your document does not meet statutory requirements, a 	
letter outlining the deficiencies will be returned to the 	original submitter	.  	
 	
 	If the document is complete and cor	rect, the document will be filed and 	a letter certifying the filing 	
of the document will be returned to	 the original submitter.	 	
 
 	If you wish a “	FILED STAMPED” copy of the document to be returned with the certification letter 	
(at no additional fee), it will	 be necessary for you to submit the original and a copy of the 	
document.  	 	
 	
 	Express	 Handling	 	
 	
 	You may request 24 hour priority 	handling 	of your document by simply marking the “24 hour priority 	
handling	” box and include an 	additional	 $20.00 with your 	handl	ing 	fee. 	 	
 	
 	You may request 1 hour expedite 	handling 	of your document by marking the “1 hour priority 	
handling	” box and include	 an 	additional	 $100.00 with your filing fee.	 	
 	
 	Please note:	  If your 	documents 	are returned for deficiencies and 	upon resubmittal	 you request either 	
of the Express Services 	you must 	also re	mit	 a new priority 	($20.00) 	or expedite 	($100.00) 	handling 	
fee	.   	
 
SUBMISSION	 	
 
Make checks payable to the Secretary of State.	 Upon completion, mail with ORIGINAL SIGNATURE to	: 	
 
Secretary of State	 	
PO Box 202801	 	
Helena, MT 59620	-2801	 	
  
CONTACT US	 	
 
If you have any questions regarding this form, please	 contact the Secretary of State	, Business	 Services 	
Division 	at (406) 444	-3665.	 	
 	
DO NOT STAPLE PAYMENT TO FILING FORM