§ 1003. Certificate of dissolution; contents.

(a) A certificate of dissolution, entitled "Certificate of dissolution
of ......... (name of corporation) under section 1003 of the Business
Corporation Law", shall be signed and delivered to the department of
state. It shall set forth:

(1) The name of the corporation and, if its name has been changed, the
name under which it was formed.

(2) The date its certificate of incorporation was filed by the
department of state.

(3) The name and address of each of its officers and directors.

(4) That the corporation elects to dissolve.

(5) The manner in which the dissolution was authorized.