ID number, entity name, and jurisdiction

These fields are all pre-filled with the entity information in the records of the Colorado Secretary of State. This information cannot be corrected by filing this document.

Principal office street address

A principal office street address is required. The street address must be a physical address and cannot be a post office box. This information may be pre-filled, but may be changed if necessary.

Provide the street name and number, including the suite, unit or apartment number, if applicable. The city, state and ZIP/postal code must also be provided. Any address outside of the United States must include the country and, if applicable, the province.

Example: 123 N. Main Street, Apt 101
               Denver, Colorado 80202

Principal office mailing address

A mailing address is optional. This information may be pre-filled, but may be changed if necessary. If the mailing address is different than the street address, or mail cannot be delivered to the street address, provide the address, including the city, state and ZIP/postal code where mail is to be delivered. Any address outside of the United States must include the country and, if applicable, the province.

Example: P.O. Box 854
               Lakewood, Colorado 80228

Statement adoption

Mark the boxes to affirm the statements. If the boxes are not marked, the document will not be accepted. Both statements are required. [1]

Additional information

Select “Yes” if additional information is permitted or required by law to be included in the document. After clicking on “Submit” at the bottom of the online form, the system will proceed to the Manage Attachments page. This will allow additional information to be attached as a plain text (.txt) or PDF (.pdf) document. Information regarding attachments

Delayed effective date (optional)

If you want the document to take effect immediately, leave “Yes” selected and the date field blank.

If you don’t want the document to become effective immediately, select “No” and enter the date and time (time is optional) that you want the document to become effective in the box. If only a date is entered into the box, then the document will become effective at 11:59 PM on that date. The effective date of filing can be delayed up to 90 days maximum. All filing dates and times are in Mountain Standard Time.  [2]

Email notification

Our office can send you email notifications about due dates and other events affecting this business record.

Notice

This section describes the legal authority for filing this document.  [3]

Individual causing delivery [4]

Each individual causing the document to be filed is responsible for complying with the applicable statutes. Provide the last name and first name of at least one individual causing the document to be delivered for filing. Enter the individual’s mailing address, including the city, state and ZIP/postal code. If the address is outside of the United States, include the country and, if applicable, the province.

Example:

Smith, John
123 N. Main St., Apt 101
Denver, Colorado 80122

Additional individuals causing delivery

If more than one person is causing this document to be filed, mark “Yes” to include an attachment with the names and addresses of additional individuals causing the document to be filed. The attachment must provide the name of each additional individual, including their last name and first name. A middle name or initial and a suffix are optional. Also provide the mailing address, including the city, state and ZIP/postal code. Any address outside of the United States must include the country and, if applicable, the province.

Disclaimer

Instructions, and the related form, are not intended to provide legal, business, or tax advice, and are offered as a public service without representation or warranty. While the related form is believed to satisfy minimum legal requirements as of its revision date, compliance with applicable law, as the same may be amended from time to time, remains the responsibility of the user of this form. Questions should be addressed to the user’s attorney.

Submit

Selecting the Submit button will navigate to either the “Manage Attachments” page or the “You’re not done yet” page to review the information. If you select Submit and the next page does not display, first check for error messages at the top of the form. Your document won’t be filed until after payment.

Note

Review the form carefully; mistakes may have legal consequences. Our office cannot provide legal advice. Questions should be addressed to your legal, business, or tax advisor(s). Only provide information that is required or permitted to be included in the document. Information included in the document must be in English, and must state the name and address of at least one individual causing the document to be delivered for filing.

Statement of Dissolution of Delinquent Entity filed pursuant to § 7-90-908 of the Colorado Revised Statutes (C.R.S.).

[1] | 7-90-908, C.R.S.
[2] | 2-4-109 and 7-90-304, C.R.S.
[3] | 7-90-301.5, C.R.S.
[4] | 7-90-301.5, C.R.S.