California Code, Corporations Code - CORP § 1401.5

(1) The name of the corporation.

(2) That an order for relief was entered in a case under Chapter 11 (commencing with Section 1101) of Title 11 of the United States Code with respect to the corporation.

(3) The identification of the court in which the order for relief was entered and the court's file number for the matter.

(4) That an order confirming a reorganization plan has been entered in that case.

(5) That the undersigned has been appointed by the court as a trustee, liquidating agent, responsible officer, or other representative of the corporation.

(6) That the shares of the corporation have been canceled pursuant to the terms of that plan.

(7) That the assets of the corporation have been distributed pursuant to the terms of that plan.

(8) That the corporation is dissolved.