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Complete and include this form with your paper submission. Enter the name and address to return an acknowledgement copy of this form to.This must be a physical address. Principal office mailing address. Complete and file the Certificate of Dissolution with the Department of State. A dissolved limited liability company may file a certificate of termination with the Secretary of State. Form CD 415 may be used for this purpose. HOW WAS THE DISSOLUTION APPROVED: Complete the information as required. If membership approval was not required, check the appropriate section. HOW WAS THE DISSOLUTION APPROVED: Complete the information as required.