Statement Of Cancellation Of Limited Liability Partnership Form (2004) Page 2
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1
2STATE OF DELAWARE
STATEMENT OF CANCELLATION
1.
The name of the limited liability partnership is __________________________
_________________________________________________________________.
2.
The original date of filing the limited liability partnership is _________________
_________________________________________________________________.
3.
The reason for filing the statement of cancellation _______________________
_______________________________________________________________.
4.
Any other information the person filing the statement of cancellation determines
to insert_________________________________________________________
_______________________________________________________________.
IN WITNESS WHEREOF, the undersigned have executed this Statement of
Cancellation this ______ day of ________________________, A.D. ______.
By:_____________________________
Authorized Partner(s)/Person
Name:___________________________
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