AMENDMENT TO APPLICATION FOR AUTHORITY (Complete only 1, 2, 8)

or

WITHDRAWAL OF AUTHORITY TO TRANSACT BUSINESS (Complete only 3, 4, 5, 6, 7, 8)

1. ENTITY NAME:  of the nonprofit as registered in Oregon.
   

2. AMENDMENT: Describe the amendment(s).
   

3. NAME : of the entity as registered in Oregon.

4. STATE OR COUNTRY OF FILING: Home jurisdiction, the state of domestic registration.
   

5. THIS CORPORATION IS NOT TRANSACTING BUSINESS IN OREGON, AND SURRENDERS ITS AUTHORITY TO TRANSACT BUSINESS IN OREGON.

6. THIS CORPORATION REVOKES THE AUTHORITY OF ITS REGISTERED AGENT… AND APPOINTS THE SECRETARY OF STATE AS ITS AGENT FOR SERVICE OF PROCESS….     
   NOTE: While the Secretary of State’s office will accept service of process, they will not provide any notification.

7. MAILING ADDRESS: Address to which a copy of documents served on the Secretary of State may be mailed to notify the nonprofit about the legal action.
   Note that the nonprofit corporation agrees to update this address in the Oregon Business Registry for a period of five years after this withdrawal.​
   

8. EXECUTION / SIGNATURE: This legal declaration must be signed. If another form is generated, this exact wording must be used​.