New York StateDepartment of State DIVISION OF CORPORATIONS, STATE RECORDS AND UNIFORM COMMERCIAL CODE One Commerce Plaza 99 Washington Ave. Albany, NY 12231-0001 CERTIFICATE OF SURRENDER OF AUTHORITY OF (Insert Name of Foreign Limited Partnership) Under Section 121-905 of the Revised Limited Partnership Act FIRST: The name of the foreign limited partnership as it appears on the index of names in the Department of State is: . If applicable, the fictitious name the foreign limited partnership has agreed to use in this state is: . SECOND: The jurisdiction where the foreign limited partnership was organized is: . THIRD: The date on which its application for authority to do business in this state was filed with the Department of State is: . FOURTH: The foreign limited partnership surrenders its authority do business in New York State. FIFTH: The foreign limited partnership revokes the authority of its registered agent, if any, previously designated, and, hereby consents that process against it in any action or special proceeding based upon any liability or obligation incurred by it within this state before the filing of the certificate of surrender may be served on the Secretary of State in the manner set forth in Section 121-109 of the Revised Limited Partnership Act. SIXTH: The address to which the Secretary of State shall mail a copy of any process against the foreign limited partnership is: . X (Signature) (Type or Print Name) (Title of Signer) DOS-1396-f (Rev. 04/17) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com CERTIFICATE OF SURRENDER OF AUTHORITY OF (Insert Name of Foreign Limited Partnership) Under Section 121-905 of the Revised Limited Partnership Act Filer222s Name and Mailing Address: Name: Company, if Applicable: Mailing Address: City, State and Zip Code: NOTES: 1. The name of the foreign limited partnership and the date of filing of its application for authority 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 was prepared by the New York State Department of State for filing a certificate of surrender of authority for a foreign limited partnership. 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. The certificate must be signed by a general partner, or by a trustee, receiver or other person authorized by law to wind up such limited partnership. This certificate must be accompanied by a fee of $60 made payable to the Department of State. (For office use only) DOS-1396-f (Rev. 04/17) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com