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The form must be filed electronically; paper forms are not accepted.
The document provided is a sample and cannot be submitted for filing.
The form requires the ID number, entity name, and jurisdiction of formation for the delinquent entity.
Information about the registered agent, including their name and address, must be provided, with caution against mixing individual and entity names.
The principal office address of the entity must be included in the form.
There is an option to state a delayed effective date for the document, which has significant legal consequences.
Individuals delivering the document affirm that it is their act and deed under penalties of perjury, ensuring compliance with legal requirements.