COVER LETTER TO: Registration Section Division of Corporations SUBJECT: DOCUMENT NUMBER: The enclosed Notice of Limited Liability Company Dissolution and fee are submitted for filing. Please return all correspondence concerning this matter to the following: (Name of Contact Person) (Firm/Company) (Address) (City/State and Zip Code) For further information concerning this matter, please call: at ( (Name of Contact Person) Enclosed is a check for the following amount: $25 Filing Fee $30 Filing Fee & ) (Daytime Telephone Number) (Area Code) Certificate of Status $60 Filing Fee, Certificate of Status & (Additional copy is enclosed) Certified Copy (Additional copy is enclosed) $55 Filing Fee & Certified Copy MAILING ADDRESS: STREET ADDRESS: Amendment Section Division of Corporations P.O. Box 6327 Tallahassee, FL 32314 Amendment Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 CR2E142 (2/14) American LegalNet, Inc. www.FormsWorkFlow.com Notice of Limited Liability Company Dissolution This notice is submitted by the dissolved limited liability company named below for resolution of payment of unknown claims against this limited liability company as provided in s. 605.0712, F.S. This "Notice of Limited Liability Company Dissolution" is optional and is not required when filing a voluntary dissolution. Name of Limited Liability Company: Document number of Limited Liability Company is: Date of dissolution was: Description of information that must be included in a written claim: Mailing address where claims can be sent: (Claims cannot be sent to the Division of Corporations) A claim against the above named limited liability company will be barred unless a proceeding to enforce the claim is commenced within 4 years after the filing of this notice. Printed Name of the Person Filing Signature of the Person Filing Fee: No charge if included with Articles of Dissolution. If filed separately $25.00 American LegalNet, Inc. www.FormsWorkFlow.com