Form August 2012 LP 907 Illinois Uniform Limited Partnership Act FILE # This space for use by Secretary of State. Secretary of State Department of Business Services Limited Liability Division 501 S. Second St., Rm. 357 Springfield, IL 62756 217-524-8008 www.cyberdriveillinois.com Payment may be made by check payable to Secretary of State. If check is returned for any reason this filing will be void. Please do not send cash. Cancellation of Certificate of Authority SUBMITINDUPLICATE Please type or print clearly. Filing Fee: $25 Approved: 1. Limited PartnershipName:________________________________________________________________ 2. Alternate Name, if any: __________________________________________________________________ 3. Assumed Name, if any: __________________________________________________________________ 4. The Limited Partnership named above is not transacting business in Illinois and surrenders its authority to do so. It revokes the authority of its agent for service of process in Illinois. It now appoints the Secretary of State as its agent for service of process for rights of action arising out of the transaction of business in this state. 5. Address to which the Secretary of State may mail a copy of any process against the Limited Partnership that may be served on him/her (P.O. Box only is unacceptable): ____________________________________________________________________________________ Street Address (P.O. Box alone is unacceptable.) ____________________________________________________________________________________ City, State, ZIP The original Certificate of Cancellation must be signed by a General Partner. The undersigned affirms, under penalties of perjury, that the facts stated herein are true, correct and complete. Dated:_____________________________________ ________________________________________ Signature __________________________________________ __________________________________________ Name and Title (type or print) ________________________________________ General Partner Name if corporation or other entity ________________________________________ Street Address, City, State, ZIP Signatures must be in black ink on an original document. Carbon copy, photocopy or rubber stamp signatures may only be used on conformed copies. Printed on recycled paper. Printed by authority of the State of Illinois. August 2012 -- 1 -- CLP 6.12 American LegalNet, Inc. www.FormsWorkFlow.com