SECRETARY OF THE STATE OF CONNECTICUT MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470 DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106 PHONE: 860-509-6003 WEBSITE: www.concord-sots.ct.gov RENUNCIATION OF STATUS REPORT DOMESTIC LIMITED LIABILITY PARTNERSHIP USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY. FILING PARTY (CONFIRMATION WILL BE SENT TO THIS ADDRESS): NAME: ADDRESS: FOR OFFICIAL USE ONLY: CITY: STATE: ZIP: 1. NAME OF THE LIMITED LIABILITY PARTNERSHIP: THE ABOVE NAMED LIMITED LIABILITY PARTNERSHIP HEREBY RENOUNCES ITS STATUS AS A REGISTERED LIMITED LIABILITY PARTNERSHIP 2. EFFECTIVE DATE OF THE RENUNCIATION: (IF OTHER THAN THE FILE DATE) 3. EXECUTION: (SUBJECT TO PENALTY OF FALSE STATEMENT) DATED THIS NAME OF PARTNER (print or type) DAY OF , 20 SIGNATURE PAGE 1 OF 1 FORM LLPR-1-1.0 Rev. 7/2015 American LegalNet, Inc. www.FormsWorkFlow.com