State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.alaska.gov/occ NOTIFICATION OF CONVERSION Foreign Limited Liability Company AS 10.50.800 & AS 10.50.570 Filing Fee: $25.00 (non-refundable) INSTRUCTIONS (Please retain for your records): Refer to Alaska Statutes 10.50.800 and 10.50.570. If a foreign company authorized to transact business in the State of Alaska is party to an organic change permitted by the laws of the home state, the surviving company shall, within 30 days file with the Commissioner a certified copy of the Articles of Conversion from the home state, along with an application for Certificate of Foreign Registration. NOTICE: The Notification of Conversion must be filed in conjunction with a Certificate of Registration of Foreign Limited Liability Company and the applicable $350.00 fee – see form 08-497. ITEM 1: Provide the name of the entity immediately before filing of the certificate of conversion to a limited liability company i.e. prior to conversion. ITEM 2: Provide the name of limited liability company as listed on the attached Certificate of Registration. Mail the Notification of Conversion and non-refundable $25.00 filing fee, along with the Certificate of Foreign Registration and $350.00 to: State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. 08-501 (Rev. 04/17/2012) Notification of Conversion Instructions American LegalNet, Inc. www.FormsWorkFlow.com State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.alaska.gov/occ DO NOT STAMP ABOVE THIS BOX Office Use Only CORP NOTIFICATION OF CONVERSION Foreign Limited Liability Company AS 10.50.800, AS 10.50.570 $25.00 Filing Fee (non-refundable) Pursuant to Alaska Statutes 10.50.800 and 10.50.570, if a foreign company authorized to transact business in the State of Alaska is party to an organic change permitted by the laws of the home state, the surviving company shall, within 30 days file with the Commissioner a certified copy of the Articles of Conversion from the home state, along with an application for Certificate of Foreign Registration. ITEM 1: Name of the converting entity: Alaska Entity # (if applicable): Attach a separate sheet with additional companies, if necessary. ITEM 2: Name of the limited liability company listed on the attached Certificate of Foreign Registration: NOTICE: The Notification of Conversion must be filed in conjunction with a Certificate of Registration of Foreign Limited Liability Company and the applicable $350.00 fee – see form 08-497. Mail the Notification of Conversion and non-refundable $25.00 filing fee, along with the Certificate of Foreign Registration and $350.00 to: State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. 08-501 (Rev. 04/17/2012) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.alaska.gov/occ DO NOT STAMP ABOVE THIS BOX Office Use Only CORP CONTACT INFORMATION SHEET Please return this document with your filing. This information will only be used to resolve questions with the filings attached. NOTE: this form will not be filed for record or appear online. Name of entity as it appears on filing: To resolve questions with this filing, contact: Name: Email: Phone: Mailing address: Return documents to: Name: Company: Mailing address: Attach this form to your filings. Send all documents to: State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. 08-561 (Rev. 02/01/2012) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com