Mail all forms and required payment to: Department of Consumer and Regulatory Affairs Corporations Division PO Box 92300 Washington, DC 20090 Phone: (202) 442 - 44 32 Corporate Online Services Information: Many corporate filings are available by using CorpOnline Service. Go to CorpOnline site at https://corp online .dcra.dc.gov , create the profile, access the online services main page and proceed. Online filers must pay by using the credit card. District of Columbia Government Corporations Division Amendment / Cancellation of Statement of Authority for Domestic Limited Liability Company Form DLC - 6 , Ver. 2 , April 2018 . Use this form to amend or cancel filed statement of authority for domestic limited liability company. ENTITY TYPE FILING F E E Domestic Limited Liability Company Refer to Corporate Fee Schedule posted online. Under the provisions of the Title 29 of D.C. Code (Business Organizations Act), the domestic filing entity listed below hereby applies for Certificate of Amendment / Cancellation and for that purpose submits the statement below. 1 .1. Name of Limited Liability Company . 2. 3. The caption of the statement being amended or canceled and the date the statement being affected became effective . 4. The contents of the amendment or a declaration that the statement being affected is canceled. 5 . Effective Date. If you sign this form you agree that anyone who makes a false statement can be punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC 247 22 - 2405; 6 .Name of the Governor or Authorized Person. 6 A. Signature of the Governor or Authorized Person. American LegalNet, Inc. www.FormsWorkFlow.com