Free Application for Revival - Massachusetts

MSC.2

FEDERAL IDENTIFICATION NO. _____________________

Fee: $100.00

The Commonwealth of Massachusetts
Examiner

William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Boston, Massachusetts 02108-1512

APPLICATION FOR REVIVAL
(General Laws, Chapter 156B, Section 108)

1. Exact name of corporation is: 2. Name of applicant is: 3. Address of applicant is: 4. State fully the applicant's relationship to, or interest in, the corporation:

5. The date of dissolution of the corporation is: 6. The corporation was dissolved under the provisions of General Laws, Chapter 156B, Section ______________ 7. Describe fully the circumstances leading to the dissolution of this corporation:

P.C.
156barev 4/5/00

8. Describe fully the activities, if any, of the corporation since dissolution:

9. Does the applicant seek a limited or general revival? If limited, state fully the reason(s) therefore, and period of time (not to exceed one year) sought for the revival:

SIGNED UNDER THE PENALTIES OF PERJURY, this ___________ day of _______________________________ , 20 _________ ,

______________________________________________________________________________________ , Signature of Applicant.

I hereby approve the within Application for Revival and, the filing fee in the amount of $ _________ having been paid, said application is deemed to have been filed with me this _____ day of _________________ , 20 _____ .

WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth