Form Va-3 - Articles Of Dissolution Of A Voluntary Association - West Virginia Secretary Of State

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Natalie E. Tennant
Penney Barker, Manager
Secretary of State
Corporations Division
1900 Kanawha Blvd E
Tel: (304)558-8000
Bldg 1, Suite 157-K
Fax: (304)558-8381
Charleston, WV 25305
Website:
E-mail:
ARTICLES OF DISSOLUTION
FILE ONE ORIGINAL
Office Hours: Monday – Friday
OF A VOLUNTARY
8:30 a.m. – 5:00 p.m. ET
(Two if you want a filed
stamped copy returned to you)
ASSOCIATION
FEE: $25.00
**** The members of the Voluntary Association adopt and file the following Articles of Dissolution for ****
the purpose of dissolving the Voluntary Association, according to the provisions of the WV Code.
1. The name of the voluntary association is: _______________________________________________
2. The date the dissolution was authorized:
_____________________________________________
3. The mailing address to which the Secretary of State may mail a copy of any notice of legal process
against the association:
__________________________________ ______________________________________________
No. & Street
City, State and Zip
4. By checking the box below you are attesting that the following statement is true.
The proposal to dissolve was duly approved by the trustees in the manner required by
the West Virginia Code.
5. Contact name and number of person to reach in case of problem with filing: (Optional, however,
listing one may help avoid return or rejection of filing if there appears to be a problem.)
Name: ______________________________________________
Phone: _______________________
Business e-mail address, if any: _________________________________________________________
6. Signature (See below *Important Legal Notice Regarding Signature):
____________________________________________________
__________________________
Signature
Date
______________________________________
Title / Capacity in which he/she is signing
(example: President, Chairman, etc.)
*Important Legal Notice Regarding Signature: Per West Virginia Code §31D-1-129. Penalty for signing false document.
Any person who signs a document he or she knows is false in any material respect and knows that the document is to be delivered
to the secretary of state for filing is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one
thousand dollars or confined in the county or regional jail not more than one year, or both.
Form VA-3
Issued by the Office of the Secretary of State
Revised 4/13

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