State of Vermont

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Office of the Secretary of State

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The form below can be printed out by hitting "Print" on your web browser. Web pages tend to print out in a long format; therefore, a more compact version of this form can be saved and printed out in the following standard word processor formats:
• tncess.doc -- DOC -- Microsoft Windows, Word, WordPad format
• tncess.wpd -- WPD -- WordPerfect Document format
• tncess.rtf -- RTF -- Rich Text Format
• tncess.txt -- TXT -- simple text format

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[ ] business has dissolved [ ] name has been changed
[ ] business is incorporating [ ] member is withdrawing without business interruption
[ ] business is changing to an LLC (list only the member(s) name who is withdrawing)

Date of cessation or change_________________________

Individual names and residences of all persons, copartners, members or corporate name and location of the principal office of the corporation, as set forth on the TRADENAME REGISTRATION.

_______________________________________________________________________________
name, street, city, state/zip
______________________________________________________________________________
name, street, city, state/zip
______________________________________________________________________________
name, street, city, state/zip
______________________________________________________________________________
name, street, city, state/zip

Certificate may be sworn to and filed by a surviving partner, member of such association, officer of such corporation, or person so doing business, his executor or administrator.

Signature_____________________________ Title_________________

Signature_____________________________ Title_________________

Signature_____________________________ Title_________________

Subscribed and sworn to before me this _______ day of______________

Notary Public Signature/commission expiration date:
____________________________________________
____________________________________________
When a person, copartnership, association or corporation ceases to do business in this state a certificate setting forth such fact and the date whereon it so ceased shall be filed with the Secretary of State, within ten (10) days after the date such business ceases. Whenever any member of such partnership or association withdraws from the business, the remaining partners or members shall within thirty (30) days file a certificate with the Secretary of State, signed and sworn by the remaining partners or members, setting forth the fact of such withdrawal, together with the date of that withdrawal. Filing of this certificate shall avoid any interruption in the period of registration remaining before the need for renewal, as if no partner or member had withdrawn.

$10.00 Filing fee must be attached to this application.
Mail one copy to the Secretary of State, keep one copy for your records.