Certificate Of Dissolution Of Limited Liability Company
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1
2Form 562 Prescribed by:
Mail this form to one of the following:
Ohio Secretary of State
Regular Filing (non expedite)
J
H
ON
USTED
P.O. Box 1329
Ohio Secretary of State
Columbus, OH 43216
Expedite Filing (Two-business day processing
Central Ohio: (614) 466-3910
time requires an additional $100.00).
Toll Free: (877) SOS-FILE (767-3453)
P.O. Box 1390
Columbus, OH 43216
Busserv@OhioSecretaryofState.gov
Certificate of Dissolution of Limited Liability Company/
Cancellation of Foreign Limited Liability Company
Filing Fee: $50
(CHECK ONLY ONE(1) BOX)
(1)
Domestic Limited Liability Company
(2)
Foreign Limited Liability Company
(For-profit or Nonprofit)
(For-profit or Nonprofit)
(140-LDS)
(131-LFS)
Jurisdiction of Formation
Name of Limited Liability Company
If foreign, name of Limited Liability Company in its jurisdiction of formation (if different)
Ohio Registration Number
Complete the information in this section if box (1) is checked.
The Limited Liability Company hereby certifies that the effective date of the dissolution is:
Date
Note: Effective date must be on or before the date of filing.
Complete the information in this section if box (2) is checked.
The undersigned limited liability company hereby certifies that it is no longer transacting business in the state of Ohio.
The limited liability company
the authority of its registered agent to accept service of process,
notices and demands on its behalf.
(Please enter 'does revoke' or 'does not revoke')
If the authority of the agent is revoked then please provide the address to which a person may mail copy of any process,
notice, or demand against the company is:
Mailing Address
City
State
ZIP Code
If this mailing address changes in the future, the limited liability company hereby agrees to notify the Ohio secretary
of state of such change.
Form 562
Page 1 of 2
Last Revised: 11/29/12
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