Statement Of Withdrawal Of Limited Liability Partnership Status
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Statement Of Withdrawal Of Limited Liability Partnership Status Form. This is a Illinois form and can be use in Limited Liability Partnership Secretary Of State.
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Tags: Statement Of Withdrawal Of Limited Liability Partnership Status, UPA-1001(E)-1102f(F), Illinois Secretary Of State, Limited Liability Partnership
DO NOT STAPLE
FORM
UPA-Withdrawal
(1001(e)/1102(f))
Illinois Uniform Partnership Act
FILE #
Statement of Withdrawal of
Limited Liability Partnership Status
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 357
Springfield, IL 62756
217-785-8960
www.cyberdriveillinois.com
This space for use by
Secretary of State.
Submit in Duplicate
This space for use by Secretary of State.
Date:
Assigned File #:
Filing Fee: $100
Approved:
Payment must be made by certified check,
cashier’s check, Illinois attorney’s check,
Illinois C.P.A.’s check or money order
payable to Secretary of State.
1. Limited Liability Partnership Name: __________________________________________________________
2. Federal Employer Identification Number (FEIN): ________________________________________________
3. State of Jurisdiction: ______________________________________________________________________
4. Effective Date of Initial Registration in Illinois:__________________________________________________
5. Status as a Limited Liability Partnership is voluntarily withdrawn.
6. Address of Chief Executive Office (P.O. Box alone and c/o are unacceptable.): ________________________
________________________________________________________________________________________
7. Illinois Registered Agent: __________________________________________________________________
Illinois Registered Office (P.O. box alone and c/o are unacceptable.): ________________________________
______________________________________________________________________________________
8. We declare, under the penalty of perjury, under the laws of the State of Illinois, that the foregoing is true,
correct and complete.
Executed on the ___________of _______________ , ___________ by at least two partners.
Day
1.
Month
Year
1.
Signature
Street Address
Name and Title (type or print)
Name if a Corporation or other Entity
2.
City/Town
State, ZIP
2.
Signature
Street Address
Name and Title (type or print)
City/Town
Name if a Corporation or other Entity
State, ZIP
Printed by authority of the State of Illinois. May 2009 – 200 – RLLP 4.4
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