C-159C Rev. 7/92
State of New Jersey
CERTIFICATE OF DISSOLUTION
Without Assets
(Title 14A:12-4. 1)
1. Name of Corporation:
2. Corporation Number:
3. Set forth the name and address of the shareholders executing the certificate OR the name, address
and title of the officer executing the certificate;
4. The corporation has no assets, has ceased doing business and does not intend to recommence doing
business, and has not made any distributions of cash or property to the shareholders within the last
24 months and does not intend to have any distribution following its dissolution.
5. The shareholders have authorized the dissolution by signing the Certificate of Dissolution in person or
by proxy, or the board and the shareholders have authorized the dissolution as provided by law, or 30
days prior written notice of the dissolution has been mailed to or personally served upon all known
directors and shareholders at their last known address and not one of them has objected to the
dissolution.
6. The shareholders/officers executing the certificate believe(s) that all of the statements in the certificate
are true under penalty of perjury.
Signature: Date:
Signature: Date:
Signature: Date:
Signature: Date:
NJ Division of Revenue, PO Box 308, Trenton, NJ 08646
Rev 7/11/05
Instructions for Form C-159C
CERTIFICATE OF DISSOLUTION, WITHOUT ASSETS
Domestic For- Profit
(Title 14A)
STATUTORY FEE: No Fee
The MANDATORY fields are:
Field # 1 -- Business Name
List the name as it appears on the records of the State Treasurer.
Field # 2 – Corporation Number
Provide the 10-digit business entity identification number issued by the State of
New Jersey.
Field # 3 -- Names(s)/ Addresses Of Shareholders Executing The Certificate or
Name, Title And Address Of The Officer Executing The Certificate
Provide the names and addresses as indicated.
ATTESTATIONS
Provide statements that indicate:
1) The corporation has no assets; has ceased doing business; does not intend to
recommence business; has not made any distributions of cash or property to
shareholders within the last 24 months; and does not intend to have any
distributions following its dissolution.
2) The shareholders have authorized the dissolution by signing the certificate in
person or by proxy; or the board and shareholders have authorized the
dissolution as provided by law; or 30 days prior, written notice of the
dissolution has been mailed to or personally served upon all known directors
and shareholders at their last known address and not one of them objected to
the dissolution.
3) The shareholders/officers executing the certificate believe(s) that all of the
statements in the certificate are true under penalty of perjury.
EXECUTION (DATE/SIGNATURE)
Have all shareholders OR any officer sign. Also, list the date of execution
(signature).
**********
These documents should be filed in duplicate.
All annual report obligations
should be satisfied prior to submitting the dissolution paperwork.
Mail to: NJ Division of Revenue, PO Box 308,Trenton, NJ 08646
