(53-19- NMSA 1978) made payable to the New Secretary of State. The . Please refer to the for the complete statutes governing a limited liability company. The can only act in an administrative capacity. We cannot offer you legal advice or opinion on your particular filing. We recommend that you consult with your own attorney and accountant if you have any legal questions concerning your limited liability company.INCLUDED IN THIS PACKET ARE INSTRUCTIONS FOR COMPLETING OUR FORMS. PLEASE FOLLOW THESE INSTRUCTIONS CAREFULLY. New Mexico Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us American LegalNet, Inc. www.FormsWorkFlow.com The undersigned limited liability company, in order to apply for a Certificate of Cancellation under the New Mexico Limited Liability Company Act, submits the following statement: 1.The name of the limited liability company is (nclude #): 2.It is organized under the laws of: 3.It is not transacting business in New Mexico. It surrenders its registration to transact business in NewMexico. It confirms the authority of its registered agent for service of process in New Mexico. Itconsents that service of process in any action, suit or proceeding based upon any cause of action arisingin New Mexico during the time the foreign limited liability company was registered to transact businessin New Mexico also may be made on such company by service upon the secretary of state.4.The address to which a person may mail a copy of any process against the limited liability company is: Dated: By Signature of Authorized Person Form FLLC-CAR (revised /) Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, N M 87501 (800)477-3632 267 www.sos.state.nm.us American LegalNet, Inc. www.FormsWorkFlow.com DOCUMENT DELIVERY INSTRUCTION FORM (You must have one Document Delivery Instruction Form for each filing being submitted) Entity Name: Mailing Address (Include city, state and zip code): Contact Name: Contact Phone Number: Contact Email: IF YOU HAVE SELECTED TO PICK UP YOUR DOCUMENTS, OUR OFFICE WILL CONTACT YOU WHEN YOUR DOCUMENTS ARE COMPLETED AND READY FOR PICK UP. DOCUMENTS WILL NOT BE HELD FOR MORE THAN 5 BUSINESS DAYS. IF YOU HAVE NOT PICKED THEM UP WITHIN THAT TIME FRAME, THEY WILL BE MAILED TO THE ADDRESS LISTED ABOVE. PLEASE CONTACT OUR OFFICE AT 800-477-3632 AND NOTIFY US IF YOU ARE NOT ABLE TO PICK THEM UP WITHIN THAT TIME FRAME. ---THANK YOU New Mexico Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us Please check how the documents are to be delivered Will Pick Up Mail to Address Above American LegalNet, Inc. www.FormsWorkFlow.com