Application For Certificate Of Conversion Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application For Certificate Of Conversion Form. This is a Alaska form and can be use in Division Of Banking Securities And Corporations Secretary Of State.
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Tags: Application For Certificate Of Conversion, 08-431, Alaska Secretary Of State, Division Of Banking Securities And Corporations
Department of Commerce, Community, and Economic Development
Corporations, Business, and Professional Licensing
CORPORATIONS SECTION
PO Box 110808
Juneau AK 99811-0808-0808
APPLICATION FOR CERTIFICATE OF CONVERSION
Limited Liability Company
Pursuant to the provisions of Alaska Statutes 10.50.570, the undersigned hereby applies for a Certificate of
Conversion to transact business as a Limited Liability Company in the State of Alaska.
1. Name of the entity immediately before the filing of the certificate of conversion to a limited liability
company:
2. Name of the limited liability company as stated in its articles of organization:
3. State or country were the entity was originally formed:
4. Date and the jurisdiction where the other entity was first created, formed, incorporated or otherwise came
into being:
Date:
Jurisdiction:
5. The future effective date to a limited liability company if the conversion is not to be effective on the date of
filing of the certificate of conversion to a limited liability company:
Signature of Manager, Member or Attorney-in-Fact
Printed Name
Title
Date
If you have specific legal questions or concerns about this filing, you are strongly advised to consult an
attorney or other professional to assist you.
The Application for Certificate of Conversion must be filed in conjunction with the Articles of Organization for
a domestic entity and $250.00. The application for a Certificate of Conversion for a foreign entity must be
filed in conjunction with the Application for Registration of a Foreign Limited Liability Company and $350.00.
Foreign entities already on record in Alaska must also file a certified copy of the conversion from its state of
domicile and a certificate of compliance. Mail the completed filing and the filing fees (in U.S. dollars) to:
State of Alaska
Corporations Section
PO Box 110808
Juneau, AK 99811
For additional information or forms please visit our web site at: www.corporations.alaska.gov
08-431 (Rev. 08/05) alh
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