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Statement Of Conversion Form. This is a Illinois form and can be use in Limited Liability Company Secretary Of State.
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Tags: Statement Of Conversion, LLC-37.10, Illinois Secretary Of State, Limited Liability Company
Illinois
Limited Liability Company Act
LLC-37.10
Form
May 2012
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 351
Springfield, IL 62756
217-524-8008
www.cyberdriveillinois.com
FILE #
This space for use by Secretary of State.
Statement of Conversion
Supplement to Form LLC-5.5
SUBMIT IN DUPLICATE
Type or Print Clearly.
This space for use by Secretary of State.
Payment may be made by check
payable to Secretary of State. If
check is returned for any reason this
filing will be void.
Filing Fee: $100
1. Name of Entity before conversion:
____________________________________________________________________
Approved:
2. Type of entity converted to a Limited Liability Company:
I Partnership
I Limited Partnership
3. Limited Partnership file number, if applicable: ____________________________________________________________
4. The agreement of conversion from a partnership or limited partnership into a Limited Liability Company has been approved
by all required partners.
5. Number of votes cast by partners entitled to vote: _________________________________.
6. If the vote was less than unanimous, number or percentage of partners required by the agreement to approve conversion:
_________________________________.
7. A limited partnership shall cease to exist upon the effective date of the conversion and the filing, or effective date of the
Articles of Organization of the Limited Liability Company.
8. Name of Entity after conversation:
____________________________________________________________________
(name must contain Limited Liability Company, LLC or L.L.C.
The undersigned affirms under penalty of perjury, having the authority to sign hereto, that this statement of conversion is to
the best of my knowledge and belief, true, correct and complete.
Dated: ___________________________
___________________________________________________
Signature
___________________________________________________
Name and Title
___________________________________________________
General Partner Name (if a corporation or other entity)
Printed by authority of the State of Illinois. September 2012 — 1 — LLC 43.2
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