Company Striking Off Application

COMPANY STRIKING OFF APPLICATION

This Company Striking Off Application (the "Application") is submitted on Applicant Company Name: with Company Registration Number: whose registered office is located at: . Receiving Authority Name: . Application Date: .

RECITALS

WHEREAS, the Applicant is a company incorporated under the applicable companies legislation and is currently registered with the appropriate register under registration number provided above;

WHEREAS, the Applicant represents that it is no longer carrying on business and that it seeks removal from the register by striking off for the reasons specified herein;

WHEREAS, the Applicant confirms that the matters required by law to be satisfied for striking off have been addressed or will be addressed in accordance with the declarations and supporting documents submitted with this Application.

NOW THEREFORE

NOW THEREFORE the Applicant applies to the Receiving Authority to strike the Applicant off the register and certifies, by the signature of an authorized officer below, that the statements contained in this Application and in the attached supporting documents are true and correct to the best of the undersigned's knowledge and belief.

1. GROUNDS FOR APPLICATION

The Applicant states that the grounds for striking off are (select all that apply) and provides a concise explanation where required:

Ceased trading / dormant Voluntary winding up completed Amalgamation / merger into another entity Other (describe below)

2. DIRECTORS' AND SHAREHOLDERS' AUTHORISATION

The Applicant certifies that the decision to apply for striking off was duly authorized by the required corporate procedure. Provide resolution particulars and dates:

3. DECLARATION OF LIABILITIES AND CREDITORS

The Applicant makes the following declarations regarding liabilities, claims and tax obligations:

The Applicant declares that it has no outstanding creditors, liabilities or contingent liabilities that would prevent striking off. All known liabilities and statutory obligations have been discharged or arrangements have been made to discharge them. The Applicant has made reasonable inquiries with tax and revenue authorities and certifies that there are no outstanding tax assessments or, if there are, arrangements have been made in respect of them.

4. SUPPORTING DOCUMENTS

The Applicant submits the following documents in support of this Application (select all that are attached):

Certified copy of board/shareholder resolution authorising striking off Statement of affairs or final accounts Evidence of tax clearance or correspondence with tax authorities Evidence of notification to creditors (where required) Other supporting documents (describe below)

5. NOTICES

For the purposes of this Application, the Applicant designates the following contact for service of notices:

6. PROCESSING FEE AND DECLARATION

The Applicant acknowledges any applicable processing fees and certifies the accuracy of this Application.

By signing below the Applicant certifies that it has complied with all statutory requirements for application for striking off, that the information provided is true and complete, and agrees to indemnify the Receiving Authority against any loss arising from any misstatement or omission contained in this Application.

7. GOVERNING LAW, ENTIRE AGREEMENT, SEVERABILITY

This Application, and any dispute or claim arising out of or in connection with it, shall be governed by and construed in accordance with the laws of the jurisdiction in which the Applicant is incorporated. This Application constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous representations or agreements. If any provision of this Application is held to be invalid, illegal or unenforceable, the remaining provisions shall remain in full force and effect.

8. AMENDMENTS, WAIVER, COUNTERPARTS

Any amendment to this Application must be made in writing and signed by an authorized representative of the Applicant and, where required, acknowledged by the Receiving Authority. No failure or delay by either party in exercising any right shall operate as a waiver of that right. This Application may be executed in counterparts and delivered by electronic transmission of an executed signature page.

ACKNOWLEDGMENTS

The Applicant acknowledges that the Receiving Authority will process this Application in accordance with applicable statutory procedures and may require additional information or documentation. Receipt of this Application by the Receiving Authority does not constitute acceptance; the Receiving Authority retains discretion to approve or refuse striking off in accordance with law.

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