(b) The certificate of surrender of authority shall set forth:
(1) the name of the foreign limited liability company as it appears on the index of names of existing domestic and authorized foreign limited liability companies of any type or kind in the department of state, and the fictitious name the foreign limited liability company has agreed to use in this state pursuant to section eight hundred two of this article;
(2) the jurisdiction where it was organized;
(3) the date on which its certificate of authority to do business in this state was filed with the department of state;
(4) that it surrenders its authority to do business in this state;
(5) that it revokes the authority of its registered agent, if any, previously designated, and that it consents that process against it in any action or special proceeding based upon any liability or obligation incurred by it within this state before the filing of the certificate of surrender may be served on the secretary of state in the manner set forth in article three of this chapter; and
(6) a post office address within or without this state to which the secretary of state shall mail a copy of any process against it served upon him or her.
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