Certificate Of Cancellation Form - North Carolina Department Of The Secretary State
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1State of North Carolina
Department of the Secretary of State
CERTIFICATE OF CANCELLATION
Registered Limited Liability Partnership
Pursuant to §59-84.2(j) or § 59-91(k) of the General Statutes of North Carolina, as applicable, the undersigned
hereby submits this Certificate of Cancellation for the purpose of cancelling its registration as a domestic or foreign
Registered Limited Liability Partnership.
1.
The name of the partnership as reflected on the application for registration:
___________________________________________________________________________________________
2.
The date of filing of the application for registration that is to be cancelled:________________________________
3.
The Secretary of State may mail a copy of any process served on the Secretary of State to the following mailing
address:_____________________________________________________________________________________
__________________________________________________. A statement of any subsequent change in the
mailing address identified above will be filed with the Secretary of State.
4.
This cancellation will be effective upon filing, unless a date and/or time is specified: _______________________
This the _______day of _______________, 20________.
_______________________________________
_______________________________________
Signature
_______________________________________
Type or Print Name and Title
Note: The filing fee for this document is $25.00.
CORPORATIONS DIVISION
P.O.BOX 29622
RALEIGH, NC 27626-06222
(January, 2002)
(Form LLP-04)
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