FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS WANTS YOU TO KNOW... Business Identity Theft is a broad term that encompasses a wide variety of crimes involving the unauthorized use of a business identity. Small and midsize companies are tempting targets for criminals. 60% of small businesses close within a year of being victims. In an effort to be more business friendly and to heighten security, the Department of State has instituted an e-mail notification process whereby business entities are sent e-mail notices when any changes are made to their records. This e-mail notice will be sent to the previous e-mail address of record. If the change was not authorized by a principal of the business entity, you will be able to notify the Department utilizing a link provided in the e-mail. The 2012 Florida Statutes 817.155 Matters within jurisdiction of Department of State; false, fictitious, or fraudulent acts, statements, and representations prohibited; penalty; statute of limitations.--A person may not, in any matter within the jurisdiction of the Department of State, knowingly and willfully falsify or conceal a material fact, make any false, fictitious, or fraudulent statement or representation, or make or use any false document, knowing the same to contain any false, fictitious, or fraudulent statement or entry. A person who violates this section is guilty of a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. American LegalNet, Inc. www.FormsWorkFlow.com FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS Attached is a form to file a Certificate of Merger pursuant to section 620.8918, Florida Statutes. This form is basic and may not meet all merger needs. The advice of an attorney is recommended. Filing Fee: Certified Copy (optional): $25.00 for each party $52.50 Send one check in the total amount payable to the Florida Department of State. Please include a cover letter containing your telephone number, return address and certification requirements, or complete the attached cover letter. Mailing Address Amendment Section Division of Corporations P. O. Box 6327 Tallahassee, FL 32314 Street Address Amendment Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 For further information, you may contact the Registration Section at (850) 245-6050. CR2E115 (12/12) American LegalNet, Inc. www.FormsWorkFlow.com COVER LETTER TO: Amendment Section Division of Corporations SUBJECT: Name of Surviving Party The enclosed Certificate of Merger and fee(s) are submitted for filing. Please return all correspondence concerning this matter to: Contact Person Firm/Company Address City, State and Zip Code E-mail address: (to be used for future annual report notification) For further information concerning this matter, please call: at ( Name of Contact Person ) Area Code and Daytime Telephone Number Certified copy (optional) $52.50 STREET ADDRESS: Amendment Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 MAILING ADDRESS: Amendment Section Division of Corporations P. O. Box 6327 Tallahassee, FL 32314 American LegalNet, Inc. www.FormsWorkFlow.com Certificate of Merger For Florida Partnership The following Certificate of Merger is submitted in accordance with s. 620.8918, Florida Statutes. FIRST: The exact name, form/entity type, and jurisdiction for each merging party are as follows: Name Jurisdiction Form/Entity Type SECOND: The exact name, form/entity type, and jurisdiction of the surviving party are as follows: Name Jurisdiction Form/Entity Type THIRD: The date the merger is effective under the governing laws of the surviving party is: . (NOTE: If survivor is a Florida partnership, effective date cannot be prior to nor more than 90 days after the date this document is filed by the Florida Department of State. If survivor is not a Florida partnership, effective date shall be as provided in the governing law of the surviving party.) FOURTH: The merger was approved by each party as required by its governing law. 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com FIFTH: If the surviving party is a foreign organization not qualified to transact business in this state, the street address and mailing address of an office which the Florida Department of State may use for the purposes of s. 620.8919(2), F.S., are as follows: Street address: Mailing address: SIXTH: Other provisions, if any, relating to the merger: 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com SEVENTH: Signature(s) for Each Party: (Merger must be signed by all general partners of each partnership and by the authorized representative of each other party.) Typed or Printed Name of Individual: Name of Entity/Organization: Signature(s): Fees: Filing Fees: $25.00 Per Party Certified Copy: $52.50 (Optional) Certificate of Status: $8.75 (Optional) 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com