CERTIFICATE
OF DISSOLUTION
STOCK CORPORATION Office of the Secretary of the State 30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 /Rev 12/1999 Please see reverse for instruction.
Space For Offke Use Only
OF COBPOBATION:
2. DATE ON WHICH DISSOLUTION WAS AUTHORIZED:
I
I
3. Complete Block (A) if Dissolution was authorized by incorporators or initial directors pi block (B) if Dissolution was authorized by directors and shareholders. (A) Place a check mark next to either 1 m 2 as appropriate: 1. None of the corporation’s shares have been issued 2. The corporation has not commenced business
The undersigned makes the following assertions in connection with the selection made under section (A) of this form: that no debt of the corporation remains unpaid; that if shares were issued, the net assets of the corporation remaining alter winding up have been distributed to the shareholders; and that a majority of the incorporators or initial directors authorized the dissolution. (B) The dissolution was approved by resolution of the board of directors and authorized by shareholders as follows: Number of votes entitled tobccast Number of votes cast in favor of dissolution Number of votes cast against dissolution
(Note: If voting by voting groups was required, please provide the above voting information CHECK THE FOLLOWING STATEMENT IF APPLICABLE
for each group)
The number of shareholder votes cast in favor of dissolution was sufficient for approval. 4. EXECUTION day of
Dated this
Print or type name of signatory
Capacity of signatory
Signature
NOTE: A corporation may only revoke its dissolution within 120 days following the effective date of such dissolution.
INSTRUCTIONS FOR COMPLETION OF CERTIFICATE DISSOLUTION STOCK CORPORATION
OF
Instructions corresnond with numbered entries on the form
1.
NAME OF CORPORATION: Pleaseprovide the complete name of the corporation as it currently appears on the records of the Secretary of the State. DATE DISSOLUTION WAS AUTHORIZED: Pleaseprovide the month, day and year on which the directors/shareholders/incorporatorsauthorized the dissolution of the corporation. COMPLETE APPROPRIATE BLOCK (A) OR (B): (4 Place a check mark next to 1 or 2 in block (A) if the dissolution was authorized by a majority of the corporation’s initial directors or incorporators. If the dissolution was authorized by resolution of the corporation’s board of directors and approved by its shareholders,provide either the number of shareholdervotes entitled to be cast, the number of shareholdervotes cast in favor of the dissolution and the number of shareholdervotes cast against the dissolution or the number of shareholdervotes entitled to be cast and the number of shareholdervotes cast in favor of dissolution along with a check mark next to the statementthat the number of shareholdervotes cast in favor of dissolution was sufficient for approval. Note: if shareholderswere entitled to vote separately by class, each class must be designatedseparately along with the required vote information for each.
2.
3.
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4.
EXECUTION: The document must be executedby an authorized official of the corporation. That person must print or type their name, state the capacity under which they sign and provide signature. The execution constitutes a legal statementunder the penalties of false statementthat the information provided in the document is true. A CORPORATION MAY ONLY REVOKE ITS DISSOLUTION WITHIN 120 DAYS FOLLOWING THE EFFECTIVE DATE OF SUCH DISSOLUTION.