DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS BUSINESS REGULATION ADMINISTRATION CORPORATIONS DIVISION Government 941 NORTH CAPITAL STREET, N.E. WASHINGTON, D.C. 20002 of the District of Columbia STATEMENT OF DISSOCIATION Pursuant to the provisions of the District of Columbia Uniform Partnership Act of 1996, We, the undersigned partners present this Statement of Dissociation for filing. We acknowledge that the making of a false statement in this application is punishable by criminal penalties under section 404 of the District of Columbia Theft and White Collar Crime Act of 1982 as amended. 1. Name of the Partnership:_____________________________________________________ 2. Street address of the partnership's chief executive offices ___________________________________________________________________________ 3. If different from the street address of the chief executive office, the street address of an office in the District of Columbia, if any: ___________________________________________________________________________ 4. Name of partner dissociated: ___________________________________________________________________________ 5. The names of the partners authorized to execute and instrument transferring real property held in the name of the partnership. May state the authority or limitation on the authority, of some or all of the partners to enter into other transactions on behalf of the partnership an dany other matter. ___________________________________ _______________________________________ Date: ________________ _________________________________________________ Signature of Partner _________________________________________________ Signature of Partner THIS FORM MUST BE EXECUTED BY AT LEAST TWO PARTNERS Mail To: DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS BUSINESS REGULATION ADMINISTRATION CORPORATIONS DIVISION 941 NORTH CAPITAL STREET, N.E. WASHINGTON, D.C. 20002 Fees Due: Filing Fee: $150.00. Make check payable to D.C. Treasurer 2000 © American LegalNet, Inc.