COMMONWEALTH OF KENTUCKY ALISON LUNDERGAN GRIMES, SECRETARY OF STATE _________________________________________________________________________________________________________________________ Division of Business Filings Business Filings PO Box 718 Frankfort, KY 40602 (502) 564-3490 www.sos.ky.gov Cancellation of Certificate of Limited Partnership (Domestic Limited Partnership) CLP __________________________________________________________________________________________ Pursuant to the provisions of KRS 14A and KRS Chapter 362, the undersigned applicant applies to cancel the certificate of limited partnership on behalf of the limited partnership named below and, for that purpose, submits the following statements: 1. The name of the limited partnership is________________________________________________________________. (The name must be identical to the name on record with the Secretary of State.) 2. The date of filing of the certificate of limited partnership is_________________________________________________. 3. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is ______________. (Delayed effective date and/or time) 4. The reason for filing the certificate of cancellation is: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 5. Any other information as determined by the general partners: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ I/We declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct. _________________________________________ __________________ _________________ ____________ Signature of General Partner Printed Name Title Date _________________________________________ __________________ _________________ ____________ Signature of General Partner Printed Name Title Date (01/12) American LegalNet, Inc. www.FormsWorkFlow.com FILING INSTRUCTIONS CANCELLATION OF CERTIFICATE OF LIMITED PARTNERSHIP NAME Use the exact name of the business entity as registered on file with the Office of the Secretary of State. DATE OF FILING State the date that the limited partnership registered to transact business in Kentucky. WHO MAY SIGN The document must be signed by all general partners. PRINCIPAL OFFICE ADDRESS The principal office is the office (in or out of this state) so designated in writing with the Office of the Secretary of State where the principal designated office of the business entity is located. This address is where all correspondence from the Office of the Secretary of State (See Document Delivery) will be mailed. EFFECTIVE DATE AND TIME/DELAYED EFFECTIVE DATE AND TIME The document will be effective on the date and time of filing, unless a delayed effective date and/or time is specified. The effective date th or the delayed effective date cannot be prior to the date the application is filed. A delayed effective date may not be later than the 90 day after the date of filing. DOCUMENT DELIVERY A file stamped postcard will be sent to the principal office address. If the applicant wishes for the document to be sent to an alternate address other than the principal office, a request must be submitted in writing affirming that request. Alternate address requests must be submitted with each document filed with the Office of the Secretary of State. NUMBER OF COPIES If filing via mail or in person, one exact or conformed copy of the documents with the filing fee must be submitted to the address below. To make a copy of the filing for delivery to the local county clerk's office, visit www.sos.ky.gov and print a copy from the organization search tool. FILING FEE The filing fee for this document is $40.00. Checks should be made payable to the "Kentucky State Treasurer." MAILING ADDRESS Alison Lundergan Grimes Office of the Secretary of State PO Box 718 Frankfort, KY 40602-0718 OFFICE LOCATION Room 154, Capitol Building 700 Capital Avenue Frankfort, KY 40601 Hours of Operation: 8:00 AM-4:30 PM ET CONTACT INFORMATION If you have any questions, please feel free to visit our website at www.sos.ky.gov or call 502-564-3490. (01/12) American LegalNet, Inc. www.FormsWorkFlow.com