15 134B Form PDF Details

Navigating the complexities of corporate changes can be a daunting task, requiring precise documentation and adherence to state regulations. The 15 134B form, known as the Docketing Statement (Changes), stands out as a crucial document for entities undergoing significant transformations in Pennsylvania. This form serves as a comprehensive tool for reporting various corporate alterations, including amendments, mergers, consolidations, divisions, conversions, corrections, terminations, revivals, and dissolutions before the commencement of business. Part I of the form gathers general information about the filing entity, such as its current name, entity number, incorporation or qualification date in Pennsylvania, state of incorporation, Federal EIN, and any specified effective date for the changes. Following this, entities must identify the nature of the change in Part II, detailing amendments to the name or registered office, changes in stock, purpose, term of existence, or other significant alterations. Subsections cater to specific processes like mergers, where additional information about merging entities is required, or divisions and consolidations, demanding details on the newly forming or consolidating entities. The form also addresses conversions between nonprofit and profit statuses, providing a structured approach to such transitions. Moreover, the document delineates the process for entities wishing to dissolve before beginning business, revive their charter or articles, or formally terminate their existence. Through its comprehensive design, the 15 134B form facilitates a smooth transition for entities undergoing these varied legal changes, ensuring compliance with Pennsylvania's regulatory environment.

QuestionAnswer
Form Name15 134B Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names134 b form, 15 134b, dscb 15 134b, docketing statement 15

Form Preview Example

Docketing Statement (Changes) DSCB:15-134B

Part I. Complete for each filing:

BUREAU USE ONLY:

 

 

 

Revenue

 

 

Labor & Industry

 

 

 

 

 

 

 

 

 

Other _____________________

 

 

 

 

File Code_________ Filed Date ____________

 

Current name of entity or registrant (survivor or new entity if merger or consolidation):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Entity number, if known:

 

 

 

Incorporation/qualification date in PA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State of Inc:

 

 

Federal EIN:

 

 

Specified effective date, if any:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Part II. Check proper box:

 

 

Amendment (complete Section A)

 

 

 

Merger, Consolidation or Division (complete Section B,C or D)

 

 

 

Consolidation (complete Section C)

 

 

 

 

 

Division (complete Section D)

 

 

 

Conversion (complete Section A & E)

 

 

 

 

 

Correction (complete Section A)

 

 

 

Termination (complete Section H)

 

 

 

 

 

Revival (complete Section G)

 

 

 

Dissolution before Commencement of Business (complete Section F)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section A – Check box(es) which pertain to changes:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Registered Office: Number & street/RD number & box number City

State

 

Zip

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purpose:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock (aggregate number of share authorized):

 

Effective date:

.

 

 

 

 

 

 

 

 

Term of Existence:

 

 

 

 

 

Other:

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section B – Merger Complete Section A if any changes to surviving entity:

 

 

 

 

 

 

 

 

 

Merging Entities are: (attach sheet for additional merging entities)

 

 

 

 

 

 

 

 

 

 

DSCB:15-134B-2

 

 

 

 

 

 

 

Entity #, if known:

 

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DSCB:15-134B-2

Inc./qual. date in PA.

 

 

 

 

 

State of Inc.

 

 

 

Effective date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name:

 

 

 

 

 

 

 

Entity #, if known:

 

 

 

 

 

 

 

 

 

 

 

 

Effective date:

Inc./qual. date in PA.

 

 

 

 

 

State of Inc.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section C - Consolidation

Consolidating Entities are: (attach sheet for additional consolidating entities)

Name:

Entity #, if known:

Inc./qual. date in PA.

State of Inc.

 

 

 

Name:

Entity #, if known:

Inc./qual. date in PA.

State of Inc.

 

 

 

Section D – Division

Forming new entity(s) named below: (attached sheet for additional entities)

Name:

 

Entity Number:

 

 

 

Name:

 

Entity Number:

 

 

 

Check one:

 

Entity named in Part I survives. (any changes, complete Section A)

 

 

Entity named in Part I does not survive.

Section E – Conversion (complete Section A)

Check one:

 

Converted from nonprofit to profit

 

Converted from profit to nonprofit

Section F – Dissolved by Shareholders or Incorporators Before Commencement of Business

Section G – Statement of Revival (complete Section A for any changes to revived entity)

Entity named in Part I hereby revives its charter or articles which were forfeited by Proclamation or expired.

Section H – Statement of Termination (attach sheet for additional entities involved)

 

 

filed in the Department of State on

 

 

is/are hereby terminated.

(type of filing made)

month/date/year

hour, if any

 

If merger, consolidation or division, list all entities involved, other than that listed in Part I:

Name:

 

 

 

Entity number:

 

 

 

 

 

Name:

 

 

 

Entity number:

 

 

 

 

 

 

 

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134 b form list conclusion process shown (part 1)

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Completing segment 2 in 134 b form list

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