Get MS F0103

11 F0103 Page 1 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P. O. BOX 136 JACKSON MS 39205-0136 PHONE 601-359-1633 FAX 601-359-1499 Mississippi LLC Certificate of Dissolution The undersigned pursuant to Mississippi Code Ann. 79-29-801 1972 amended 2010 hereby executes the following Certificate of Dissolution and sets forth Name of Limited Liability Company 2. The reason for filing the Certificate of Dissolution 3. The future effective date of dissolution Any other information the members or managers determine to include By Signature Printed Name Please keep writing within box Title Physical address P O Box City State Zip 5 Zip4 Make Check for 50. 00 payable to SECRETARY OF STATE* Mail completed form with payment to SECRETARY OF STATE PO BOX 136 JACKSON MS 39205-0136. For assistance contact a customer service representative at 800 256-3494. Visit our website at www. The reason for filing the Certificate of Dissolution 3. The future effective date of dissolution Any other information the members or managers determine to include By Signature Printed Name Please keep writing within box Title Physical address P O Box City State Zip 5 Zip4 Make Check for 50. 00 payable to SECRETARY OF STATE* Mail completed form with payment to SECRETARY OF STATE PO BOX 136 JACKSON MS 39205-0136. 00 payable to SECRETARY OF STATE* Mail completed form with payment to SECRETARY OF STATE PO BOX 136 JACKSON MS 39205-0136. For assistance contact a customer service representative at 800 256-3494. Visit our website at www. The reason for filing the Certificate of Dissolution 3. The future effective date of dissolution Any other information the members or managers determine to include By Signature Printed Name Please keep writing within box Title Physical address P O Box City State Zip 5 Zip4 Make Check for 50. 00 payable to SECRETARY OF STATE* Mail completed form with payment to SECRETARY OF STATE PO BOX 136 JACKSON MS 39205-0136. For assistance contact a customer service representative at 800 256-3494. Visit our website at www. .