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Certificate Of Conversion From Limited Liability Company To Statutory Trust Form. This is a Delaware form and can be use in Division Of Corporations Department Of State.
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Tags: Certificate Of Conversion From Limited Liability Company To Statutory Trust, Delaware Department Of State, Division Of Corporations
Delaware Division of Corporations
401 Federal Street – Suite 4
Dover, DE 19901
Phone: 302-739-3073
Fax: 302-739-3812
Certificate of Conversion from a
Delaware or Non-Delaware Limited Liability Company
to a Delaware Statutory Trust
Dear Sir or Madam:
Enclosed please find a form for a Certificate of Conversion from a Delaware or
Non-Delaware Limited Liability Company to a Delaware Statutory Trust. The fee to file
the Certificate of Conversion is $200.00. Also, enclosed please find a form for a
Certificate of Trust that is required to be filed simultaneously with the Certificate of
Conversion. The fee for filing the Certificate of Trust is $200.00. Please submit the
filing with 1 cover sheet with Conversion first. You will receive a stamped “filed” copy
of your document. If you would like a certified copy it will be an additional $60.00.
($30.00 for the Conversion and $30.00 for the Certificate of Trust) Expedited services are
available please contact our office concerning these fees. Delaware entities converting to
any other non-Delaware or domestic entity must also pay all applicable taxes. Please
contact our Franchise Tax Department for assistance. Please make any check payable to
“Delaware Secretary of State”.
In order to process your request in a timely manner, please include a cover letter
with your name, address and telephone/fax number to enable us to contact you if
necessary. For your convenience a cover sheet is available at the following link.
http://www.state.de.us/corp/filingmemo.pdf. Please make sure you thoroughly complete
all information requested on these forms. It is important that the execution be legible, we
request that you print or type your name under the signature line.
Thank you for choosing Delaware as your corporate home. Should you require
further assistance in this or any other matter, please don’t hesitate to call us at (302) 7393073.
Sincerely,
Department of State
Division of Corporations
Rev 09/05
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STATE OF DELAWARE
CERTIFICATE OF CONVERSION
FROM A LIMITED LIABILITY COMPANY TO A
STATUTORY TRUST PURSUANT TO
SECTION 3820 OF THE DELAWARE
STATUTORY TRUST CODE
1.) The jurisdiction where the Limited Liability Company first formed is_________
______________________________________________________.
2.) The jurisdiction immediately prior to filing this Certificate is________________.
3.) The date the Limited Liability Company first formed is_____________________.
4.) The name of the Limited Liability Company immediately prior to filing this
Certificate is_______________________________________________________.
5.) The name of the Statutory Trust as set forth in the Certificate of Trust is
_________________________________________________________________.
IN WITNESS WHEREOF, the undersigned have executed this Certificate on the
___________day of _________________, A.D._______________.
By:____________________________
Trustee(s)
Name:____________________________
Print or Type
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STATE of DELAWARE
CERTIFICATE of TRUST
This Certificate of Trust is filed in accordance with the provisions of the Delaware
Statutory Trust Act (Title 12 of the Delaware Code, Section 3801 et seq.) and sets forth
the following:
• First: The name of the trust is ____________________________________________
___________________________________________________________________
• Second: The name and address of the trustee or the Registered Agent is (circle which
one applies as meeting the requirements of subsection 3807): __________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
• Third: (Insert any other information the trustees determine to include therein.)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
By:___________________________
Trustee(s)
Name:________________________
Typed or Printed
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