Telephone: 614.466.3910 
                                   Toll-free: 877.767.3453   
                                   OhioSoS.gov  |  business@OhioSoS.gov 
                                   File online or for more information: OhioBusinessCentral.gov

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Name (Individual or Business Name):

Email Address (Required):

To the Attention of (If Necessary):

Address:

City:

State                                                                   ZIP Code:

Phone Number:

                            SERVICE TYPE - Check only ONE item below.

Expedited Fees are IN ADDITION to the filing fee on the form. 
Failure to include the expedite fee or indicate a selection will result in regular service.

 Regular Service
         · No Expedite Fee. 
         · Processing Time: 3-7 business days. 

 Expedite Service 1
         · Fee: $100 
         · Processing Time: 2 business days after receipt. 

 Expedite Service 2
         · Fee: $200 
         · Processing Time: 1 business day after receipt. 

 Expedite Service 3 (in-person delivery is required)
         · Fee: $300 
         · Processing Time: 4 hours if received by 1:00 p.m. If received after 1:00 p.m., documents will be 
         processed by noon the following business day. 

 Preclearance Filing
         · Fee: $50 
         · Processing Time: 1-2 business days after receipt. 
Form 560                                       Page 1 of 6                                 Last Revised: 10/2024

Form 560 Prescribed by:                                      INSTRUCTIONS                                   MAIL TO
                                                             · Include the filing fee.                      Regular Service: 
                                                             · Make check or money order payable to         P.O. Box 1329 
                                                             Ohio Secretary of State.                       Columbus, OH  43216 
                                                             · Print on single-sided 8 ½ x 11 paper.        OR 
                                                             · Double sided paper will be rejected.         Expedite Service: 
                                                             · Information must be typed.                   P.O. Box 1390 
                                                             · Illegible forms will be rejected             Columbus, OH  43216
For screen readers, follow instructions located at this path.

                                     Certificate of Dissolution 
                                     (Nonprofit, Domestic Corporation) 
                                                               Filing Fee: $50 
                        (139-DISM (Members) & 175-DIST (Directors)) 
                                                             Form Must Be Typed 

Complete the following information.

The corporation named below has adopted a resolution of dissolution. 

Name of Corporation

Charter Number

Location of Principal Office in Ohio 

                                                                                                                   OH
City                                                                                                 County        State

Names and addresses of the directors.

Name                                                                      Address

Name                                                                      Address

Name                                                                      Address

Form 560                                                       Page 2 of 6                                  Last Revised: 10/2024

Names and addresses of the officers. 

Name                                                       Address

Name                                                       Address

Name                                                       Address

Name and address of the Statutory Agent. 

Name of Statutory Agent

Agent Address (Post office boxes and CMRAs are NOT allowed. See instructions for details.)

                                                                           OH
City                                                                       State          ZIP Code

Please complete this section if the corporation is appointing a new agent. 

                           ACCEPTANCE OF APPOINTMENT 

The Undersigned,                                                                   , named herein as the
                    Statutory Agent Name

Statutory agent for,
                    Corporation Name

hereby acknowledges and accepts the appointment of statutory agent for said corporation. 

Statutory Agent Signature
                         Individual Agent's Signature/Signature on behalf of Business Serving as Agent

The date of dissolution if other than the filing date 
                                                      dissolution date (MM/DD/YYYY)

Note: The date of dissolution must be on the date of filing, or a later date that is not more than 90 days after the date 
of filing, pursuant to Ohio Revised Code section 1702.47(H)

Form 560                                       Page 3 of 6                                Last Revised: 10/2024

Check the appropriate box and provide information as required:

 The resolution of dissolution was adopted by the Directors. Pursuant to Ohio Revised Code section 
 1702.47(C), directors may adopt a resolution in the following cases, please check the box to state the proper 
 statement of the basis for the adoption.

         When the corporation has been adjudged bankrupt or has made a general assignment for the benefit of 
         the creditors;
         By leave of the court, when a receiver has been appointed in a general creditor's suit or in any suit in 
         which the affairs of the corporation are to be wound up;
         When substantially all of the assets have been sold at judicial sale or otherwise; or
         When the period of existence of the corporation specified in its articles has expired.

 The resolution of dissolution was adopted by the Members pursuant to Ohio Revised Code section 
 1702.47(D).

By signing and submitting this form to the Ohio Secretary of State, the undersigned hereby certifies that he or she 
has the requisite authority to execute this document.
Required     
 
Must be signed by an authorized      Signature
officer, unless the officer fails to 
execute and file the certificate 
within30 days after the adoption 
                                     By (if applicable)
of the resolution, or upon any 
date specified in the resolution as 
the date upon which the 
certificate is to be filed, or upon  Print Name
the expiration of any period 
specified in the resolution as the 
period within which the certificate 
is to be filed,whichever is latest, 
in which event the certificate of    Signature
dissolution may be signed by any 
three voting members and shall 
set forth a statement that the 
                                     By (if applicable)
persons signing the certificate are 
voting members and are filing the 
certificate because of the failure 
of the officers to do so.            Print Name
 
If authorized representative is an 
individual,then they must sign in 
the "signature"box and print their 
name in the "Print Name" box.        Signature
 
If authorized representative is a 
business entity,not an individual, 
then please print the business       By (if applicable)
name in the "signature" box, an 
authorized representative of the 
business entity must sign in the 
"By" box and print their name in     Print Name
the"Print Name" box.
Form 560                                       Page 4 of 6                                     Last Revised: 10/2024

Complete the information in this section.

                                                AFFIDAVIT
                           In lieu of dissolution releases from various governmental authorities.

                                                Name of Corporation

The undersigned, being first duly sworn, declares that on the dates indicated below, each of the named state governmental 
agencies was advised IN WRITING of the scheduled date of filing of the Certificate and was advised IN WRITING of the 
acknowledgement by the corporation of the applicability of the provisions of section 1702.55 of the ORC. 

Agency                      Date Notified       Agency                                                           Date Notified 
                            (MM/DD/YYYY)                                                                         (MM/DD/YYYY)
Ohio Department of Taxation                     Ohio Job & Family Services 
Dissolution Section                             Status and Liability Section 
4485 Northland Ridge Blvd.                      Data Correspondence Control 
Columbus, Ohio  43229                           Fax:        614-752-4811 
                                                Phone:  614-466-2319
                                                Overnight Address:                       Regular Address: 
                                                P.O. Box 182413                          P.O. Box 182413 
                                                Columbus, OH 43218-2413                  Columbus, OH 43218-2413

Note: This affidavit  must be signed by the person executing the certificate or by an officer of the corporation.

Signature                                                                Title

Name

Mailing Address

City                                                                                     State                   ZIP Code

State of

County of

Sworn to or affirmed and subscribed before me by
                                                Name of person making oath or affirmation

                            on this date
                                                Today's Date (MM/DD/YYYY)
         NOTARY SEAL

                                                Notary Public’s Signature

                                                Expiration Date of Notary’s Commission (MM/DD/YYYY)

Form 560                                        Page 5 of 6                                        Last Revised: 10/2024

                        Instructions for Certificate of Dissolution

This form should be used for a nonprofit, domestic corporation to file a certificate of dissolution pursuant to Ohio 
Revised Code section 1702.47. 
 
Corporation Information 
Please provide the name of the corporation and the charter number assigned by our office.  
 
Also, please provide the location of the principal office in Ohio including the city and county. 
 
Director and Officer Information 
Please provide the names and addresses of the directors and officers of the corporation.   
 
Appointment of Agent          
Ohio business entities and foreign business entities that are registered or licensed in Ohio must appoint and 
maintain a statutory agent to accept service of process. The statutory agent must be one of the following: (1) A 
natural person residing in Ohio; or (2) a domestic or foreign business entity with an Ohio address. 
 
Statutory Agent Address Requirements 
A statutory agent address may either be the primary residence address of the agent or the usual place of 
business address. The statutory agent address must be an Ohio address. 
 
Statutory Agent Address Prohibitions 
Post Office (P.O.) boxes are NOT allowed. 
 Exception: If a Post Office Box and Rural Route Number are both provided, the address is allowed. 
Commercial Mail Receiving Agency (CMRA) addresses are        NOT allowed. A CMRA is a private business that 
rents private mailboxes to customers. 
 
Acceptance of Appointment 
The statutory agent must sign the Acceptance of Appointment. 
 
Date of Dissolution 
Pursuant to Ohio Revised Code section 1702.47(H), the date of dissolution must be on the date of filing with our 
office, or a later date specified that is not more than 90 days after the date of filing. 
 
Statement of Manner and Basis for Dissolution  
Pursuant to Ohio Revised Code section 1702.47(E)(3), the certificate must provide a statement of the manner of 
adoption of the resolution of dissolution, and in the case of its adoption by the directors, a statement of the basis 
of the adoption. Please check the appropriate box to state the resolution of adoption was adopted by the Directors 
or Members. If adopted by Directors, please check one of the four boxes to state the basis for the adoption, as 
stated in Ohio Revised Code section 1702.47(C).   
 
Additional Provisions 
If the information you wish to provide for the record does not fit on the form, please submit additional provisions 
on a single-sided, 8 ½ x 11 sheet(s) of paper.   
 
Signature(s) 
After completing all information on the filing form, please make sure that page 3 is signed by an authorized officer, 
pursuant to Ohio Revised Code section 1702.47.    
 
**Note:  Our office cannot file or record a document which contains a social security number or tax 
identification number. Please do not enter a social security number or tax identification number, in any 
format, on this form.  

Form 560                                         Page 6 of 6                                     Last Revised: 10/2024