Certificate Of Conversion From A Delaware Or Non-Delaware Limited Liability Company To A Delaware Corporation - Delaware Division Of Corporations - 2005 Page 2

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STATE OF DELAWARE
CERTIFICATE OF CONVERSION
FROM A LIMITED LIABILITY COMPANY TO A
CORPORATION PURSUANT TO SECTION 265 OF
THE DELAWARE GENERAL CORPORATION LAW
1.) The jurisdiction where the Limited Liability Company first formed is
________________________________________________________________.
2.) The jurisdiction immediately prior to filing this Certificate is________________.
3.) The date the Limited Liability Company first formed is_____________________.
4.) The name of the Limited Liability Company immediately prior to filing this
Certificate is
_______________________________________________________.
5.) The name of the Corporation as set forth in the Certificate of Incorporation is
________________________________________________________________.
IN WITNESS WHEREOF, the undersigned being duly authorized to sign on behalf
of the converting Limited Liability Company have executed this Certificate on the
___________day of _________________, A.D._______________.
By:_____________________________
Name:
_____________________________
Print or Type
Title:______________________________
Print or Type

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