Foreign Limited Liability Company Cancellation Checklist 

The attached application must be filled out in its entirety. All 
fields withasteriskan    *are required.

The filing fee is $25. Please make the check or money order payable 
to New Mexico Secretary of State or NMSOS.  

Mail entire application along with the required information listed above to: 

           New Mexico Secretary of State 
                          Business Services Division 
                          325 Don Gaspar, Suite 300 
                          Santa Fe, NM 87501 

      Type or Print 
      Legibly $25 Filing 
      Fee 

                                                                                                                                   Foreign Limited Liability Company 

                                                                                                                     Application for Cancellation of Registration 
                 The undersigned limited liability company  order toin apply for a Certificate of Cancellation Under the New Mexico      ,                                                                                               
                                                                                                  Limited Liability Company Act  submits the following statement:,

                 1:*The business ID number,                                                                                        ,nameandDBA name(s)theof       limited liability company: 

                 2. *It is organized under the laws of:

                 3. The limited liability company is not transacting business in New Mexico. It surrenders its registration to transact 
                 business in New Mexico. It confirms the authority of its registered agent  for service of process in New Mexico. It 
                 consents that services of process in any action, suit or proceeding based upon any cause of action arising in New 
                 Mexico during the time the foreign limited liability company was registered to transact business in New Mexico also 
                 may be made on such company by service upon the secretary of state.

                 4. *The address to which a person may mail a copy of any process against the limited liability company is:

                 5.                                   *I confirm that the foreign limited liability company has resigned as a registered agent or is not currently 
                 a               registered agent anyfor entity registered Newin Mexico.

                 *Executed Date: 

                                                                                                                                                                                    *Printed Name and Title of Authorized Person 

                                                                                                                                                                                    Signature of Authorized Person 

      /202 Rev 0                            5         1                                                                                                                                                                          Page 1 

                                                                                                             Document Delivery Instruction Form 

                                                                                                             Please fill out in its entirety  

Contact Name: 

Contact Phone Number: 

Attention: 

Mailing Address: 

                                                  City                                                         State                                          Zip code 

Email Address: 

                                                  willdocuments All be  mailed to the                        e       email address listed. If an email 
                                                                  address is not provided the documents will be mailed to the address 
                                                                                                               listed. 

                                                                                                             check if you choose to pick up your documents 
    Documents listed pick up mustfor be withinup picked      five business days or documents will be  mailed.                                                          e

Rev 05/2021