Cancellation Of Statement Of Domestic Qualification Form - Commonwealth Of Kentucky Secretary Of State

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C
K
OMMONWEALTH OF
ENTUCKY
T
G
, S
S
REY
RAYSON
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Corporations
Cancellation of Statement of Domestic Qualification DQC
Business Filings
(Domestic)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
Please note: This document is for domestic limited liability partnerships formed after
July 12, 2006.
__________________________________________________________________________________________
Pursuant to the provisions of KRS 362, the undersigned applies to cancel the statement of qualification that was formed
after July 12, 2006, and for that purpose submits the following statement:
1. The name of the domestic limited liability partnership of record with the Office of the Secretary of State is
_________________________________________________________________________________________.
2. The date the Statement of Qualification was filed with the Office of the Secretary of State_______________________.
3. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date
__
or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is ____________
.
(Delayed effective date
and/or time)
4. The limited liability partnership cancels its Statement of Qualification.
We/I declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
_________________________________________________________________________________________________
Signature of Partner
Printed Name of Partner
Date
_________________________________________________________________________________________________
Signature of Partner
Printed Name of Partner
Date
(08/10)

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