Page 1of 2DOS-1530-f (Rev. 04/17) New York StateDepartment of State DIVISION OF CORPORATIONS, STATE RECORDS AND UNIFORM COMMERCIAL CODE One Commerce Plaza 99 Washington Ave. Albany, NY 12231-0001 www.dos.ny.govCERTIFICATE OF WITHDRAWAL OF (Insert Name of Domestic Registered Limited Liability Partnership) Under Section 121-1500(f) of the Partnership Law FIRST: The name of the registered limited liability partnership is: . If the name of the registered limited liability partnership has been changed, the name under which it was registered is: . SECOND: The date the certificate of registration was filed with the Department of State is: . THIRD: The address of the registered limited liability partnership222s principal office is: . FOURTH: The registered limited liability partnership acknowledges that this withdrawal terminates its status as a registered limited liability partnership. X (Signature of Partner) (Print or Type Name of Signer) American LegalNet, Inc. www.FormsWorkFlow.com Page 2of 2DOS-1530-f (Rev. 04/17) CERTIFICATE OF WITHDRAWAL OF (Insert Name of Domestic Registered Limited Liability Partnership) Under Section 121-1500(f) of the Partnership Law Filer222s Name and Mailing Address: Name: Company, if Applicable: Mailing Address: City, State and Zip Code: NOTES: 1. The name of the registered limited liability partnership and the date the certificate of registration was filed by the Department of State provided on this certificate must exactly match the records of the Department of State. This information should be verified on the Department of State222s website at www.dos.ny.gov. 2. This form has been prepared by the New York State Department of State for filing a certificate of withdrawal for a domestic registered limited liability partnership. This form does not contain all optional provisions under the law. You are not required to use this form. You may draft your own form or use forms available at legal stationery stores. 3. The Department of State recommends that legal documents be prepared under the guidance of an attorney. 4. This certificate must be accompanied by a fee of $60 made payable to the Department of State. (For DOS Use Only) American LegalNet, Inc. www.FormsWorkFlow.com