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Certificate of Surrender of Authority (New York)

This is a certificate of surrender of authority of a foreign limited liability company in New York. The form provided here is simply a sample of what the actual Form DOS-1379 looks like.

NYS Department of State
Division of Corporations, State Records and UCC
41 State Street, Albany, NY 12231-0001
www.dos.state.ny.us


CERTIFICATE OF SURRENDER OF AUTHORITY
OF

____________________________________
(Insert name of Foreign Limited Liability Company)

Under Section 806 of the Limited Liability Company Law

FIRST: The name of the limited liability company as it appears on the index of records in the Department of State is:

____________________________________

(If applicable, the fictitious name the foreign limited liability company has agreed to use in this state is):

____________________________________

SECOND: The jurisdiction where the limited liability company was organized is:

____________________________________

THIRD: The date on which its certificate of authority to do business in this state was filed with the Department of State is:

____________________________________

FOURTH: The limited liability company surrenders its authority to do business in New York State.

FIFTH: The limited liability company hereby revokes the authority of its registered agent, if any, previously designated and it hereby consents that process against it in any action or special proceeding based upon any liability or obligation incurred by it within this state before the filing of the certificate of surrender may be served on the secretary of state in the manner set forth in Article 3 of the Limited Liability Company Law.

SIXTH: The address within or without this state to which the secretary of state shall mail a copy of any process against the limited liability company served upon him or her

is: ____________________________________


____________________________________ (Signature)

____________________________________ (Type or print name)

____________________________________ (Title or capacity of signer)


CERTIFICATE OF SURRENDER OF AUTHORITY
OF

____________________________________
(Insert name of Foreign Limited Liability Company)

Under Section 806 of the Limited Liability Company Law


Filed by: ____________________________________ (Name)

____________________________________ (Mailing address)

____________________________________ (City, State and ZIP code)

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