PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Return document by mail to:
Name
Address
City
State
Zip Code
Return document by email to:
_________________________________
Read all instructions prior to completing.
Fee: $70
In compliance with the requirements of the applicable provisions of 15 Pa.C.S. § 8434 (relating to certificate of
denial of partnership authority), the undersigned person desiring to effect a certificate of denial of partnership authority
hereby states that:
1. The name of the general partnership is:
_________________________________________________________________
2. Complete part (a) OR (b) – not both:
(a) The partnership is a domestic general partnership or limited liability partnership and the address, including
number and street, if any, of its principal place of business:
___________________________________________________________________________________________________
Number and street of principal office
City
State
Zip
County
(b) The partnership is a registered foreign limited liability partnership and the (1) address of its current registered
office in this Commonwealth or (2) name of its commercial registered office provider and the county of venue is:
(Complete (1) or (2), not both)
(1) ________________________________________________________________________________________________
Number and Street
City
State
Zip
County
(2) ________________________________________________________________________________________________
Name of Commercial Registered Office Provider
County
3. The caption of the Certificate of Authority to which this denial pertains. Additional pages may be attached as
needed.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
4. I deny the grant of authority in the caption listed above.
IN TESTIMONY WHEREOF, the undersigned has caused this Certificate of Denial of Partnership Authority to be signed
thereof this _______ day of ___________________, 20_______.
______________________________________________________________
Name of Partnership
______________________________________________________________
Signature
______________________________________________________________
Title