How to write the information required by the tax bureau when canceling?

* * Tax official:

Our company * * * * was established on * *, and the tax registration certificate number is * * *; Enterprise legal person: *; Business address: * * * *, business scope of the company: * * * * * Due to poor management, it was unable to carry out business normally and was dissolved by resolution of the shareholders' meeting. I hereby apply to your bureau for cancellation, and hope for approval.

I am here to convey

I hope I can help you.