BUSINESS REGISTRATION DIVISION P. O. BOX 29622 RALEIGH, NC 27626-0622 (Revised July, 2017) (Form BE-16) Instructions for Filing ARTICLES OF CONVERSION To Foreign Entity (Form BE-16) This form should only be used by a domestic business entity for the purpose of converting to a foreign business entity that is not authorized to transact business or conduct affairs in this state. If the domestic business entity is converting to a business entity whose formation or whose status as a registered liability partnership, as defined in G.S. 59-32, or limited liability partnership, as defined in G.S. 59-102, requires the filing of a document with the Secretary of State, then the articles of conversion shall be included as part of that document instead of separately filing the articles of conversion. Item 1 Enter the complete name of the converting business entity. Item 2 State whether the converting business entity is a domestic corporation, limited liability company, limited partnership, registered limited liability partnership or domestic partnership. Item 3 Enter the mailing address of the converting business entity prior to the conversion. Item 4 Enter the name of the resulting business entity. Item 5 State whether the resulting business entity is a foreign corporation, limited liability company, limited partnership, limited liability partnership or foreign partnership. Item 6 Enter the name of the state or country whose laws govern the resulting business entity222s organization and internal affairs. (Note, this cannot be North Carolina.) Item 7 Enter the mailing address of the resulting business entity. Item 8 See form. Item 9 The document will be effective on the date and at the time of filing, unless a delayed date or an effective time (on the day of filing) is specified. If a delayed effective date is specified without a time, the document will be effective at 11:59:59 p.m. on the day specified. If a delayed effective date is specified with a time, the document will be effective on the day and time so specified. A delayed effective date may be specified up to and including the 90th day after the day of filing. Date and Execution Enter the date the document was executed. In the blanks provided enter: The name of the converting business entity. The signature of the representative of the converting business entity. Business Corporation/Nonprofit Corporation: the document must be signed by the Chairman or any other Officer of the Corporation. Limited Liability Company: the document must be signed by a Company Official of the LLC. Limited Partnership/Limited Liability Partnership: the document must be signed by a General Partner of the LP/LLP. The name and title of the appropriate representative signing the document. American LegalNet, Inc. www.FormsWorkFlow.com BUSINESS REGISTRATION DIVISION P. O. BOX 29622 RALEIGH, NC 27626-0622 (Revised July, 2017) (Form BE-16) State of North Carolina Department of the Secretary of State ARTICLES OF CONVERSION To a Foreign Entity Pursuant to 247247 55-11A-12, 57D-9-32, 59-73.22, or 59-1062 of the General Statutes of North Carolina, as applicable, the undersigned converting business entity does hereby submit these Articles of Conversion for the purpose of converting to a different business entity. 1. The name of the converting business entity is. 2. The converting business entity is a (check one) domestic corporation; domestic limited liability company; domestic limited partnership; domestic registered limited liability partnership; or domestic partnership. 3. The mailing address of the converting entity prior to the conversion is: . 4. The name of the resulting business entity is:. 5. The resulting business entity is a (check one) foreign corporation; foreign limited liability company; foreign limited partnership; foreign limited liability partnership; or other partnership as defined in G..S. 59-36 not formed under the laws of North Carolina. 6. The organization and internal affairs of the resulting business entity are governed by the laws of the state or country of . 7. The resulting business entity is not authorized to transact business or conduct affairs in this State. The mailing address of the resulting business entity is: . The resulting business entity will file a statement of any subsequent change in its mailing address with the North Carolina Secretary of State. 8. A plan of conversion has been approved by the converting business entity as required by law. 9. These articles will be effective upon filing, unless a date and/or time is specified: This the day of , 20. Name of Converting Entity Signature Type or Print Name and Title NOTES: 1. Filing fee is $50. This document must be filed with the Secretary of State. American LegalNet, Inc. www.FormsWorkFlow.com