Withdrawal of Recognition Form

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1. State League is in *This question is required.

2. League ID # (state abbreviation + 3 digits) *This question is required.

3. Name and contact email of president of local League (or person with whom state LWV is dealing) *This question is required.

4. By initialing this box, I confirm the state LWV president has approved this withdrawal of recognition. *This question is required.

5. Short explanation of reason(s) for disbandment: *This question is required.

6. State League approval for disbandment was given on: *This question is required. This question requires a valid date format of MM/DD/YYYY.

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7. Have outstanding state and national PMPs been paid? *This question is required.

8. Have remaining funds been turned over to state LWV? *This question is required.

9. Has the change in League status been communicated to members? *This question is required.

10. Please attach a list of members to be transferred to state League.

11. Have all other members been deactivated in the database? *This question is required.

12. Name and email address of representative completing this request: *This question is required.