LP-103A (7/03) New Jersey Division of Revenue Certificate of Cancellation of Authority Foreign Limited Partnership ( Title NJSA 42:2A-59 ) 1. Name of Limited Partnership: 2. Limited Partnership Number: 3. Established under the Laws of: 4. Date of Qualification in New Jersey: 5. Reason for filing the Certificate of Cancellation is: 6. Effective date of Certificate, if subsequent to date of filing is: 7. Additional Information by all General Partners Includes: Signature: General Partner Date: Name and Title (Please Print or Type) NJ Division of Revenue, PO Box 308, Trenton, NJ 08625 American LegalNet, Inc. www.USCourtForms.com Rev 7/05 Instructions for Form LP-103A CERTIFICATE OF CANCELLATION FOREIGN LIMITED PARTNERSHIP (Title 42:2A) STATUTORY FEE: $75 The MANDATORY fields are: Field # 1 -- Business Name List the name as it appears on the records of the State Treasurer. Field # 2 ­ Limited Partnership Number Provide the 10-digit business entity identification number issued by the State of New Jersey. Field # 3 -- Home Jurisdiction List the state in which the LP was formed. Field # 4 ­ Qualification Date List the date qualified to do business in New Jersey. Field # 5 -- Reason For Filing Specify the reason for filing the cancellation. Field # 6 ­ Effective Date Specify the effective date if it is other than the filing date. The effective date cannot be before the filing date nor can it be more than 30 days after the filing date. The filing date is the date the document is received for processing. Field # 7 ­ Additional Information (Optional) Include specific details of the cancellation EXECUTION (DATE/SIGNATURE) Have a general partner sign. If there is no existing general partner, have the limited partner(s) sign in accordance with Title 42:2A. Also, list the date of execution (signature). ********** These documents should be filed in duplicate. Non-profits should file in triplicate. All annual report obligations should be satisfied prior to submitting the dissolution paperwork. Make payable to: TREASURER, STATE OF NEW JERSEY. (No cash, please) Mail to: NJ Division of Revenue, PO Box 308, Trenton, NJ 08646 American LegalNet, Inc. www.USCourtForms.com