Certificate Of Dissolution Of Limited Liability Company Page 2
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2By signing and submitting this form to the Ohio Secretary of State, the undersigned hereby certifies that he or she
has the requisite authority to execute this document.
Required
Signature
Must be signed by an
authorized representative.
If authorized representative
By (if applicable)
is an individual, then they
must sign in the "signature"
box and print their name
in the "Print Name" box.
Print Name
If authorized representative
is a business entity, not an
individual, then please print
the business name in the
"signature" box, an
authorized representative
Signature
of the business entity
must sign in the "By" box
and print their name in the
"Print Name" box.
By (if applicable)
Print Name
Signature
By (if applicable)
Print Name
Form 562
Page 2 of 2
Last Revised: 11/29/12
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