PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Domestic Registered Limited Liability Partnership (15 Pa.C.S.) Statement of Amendment (§ 8201B) Statement of Termination (§ 8201C) Document will be returned to the name and address you enter to the left. Name Address City State Zip Code Fee: $70 In compliance with the requirements of 15 Pa.C.S. § 8201 (relating to amendment of registration/statement of termination), the undersigned desiring to amend/terminate its registration as a domestic registered limited liability partnership, hereby certifies that: 1. The name of the domestic registered limited liability partnership is: 2. Complete one of the following: The partnership is a general partnership and the address, including number and street, if any, of its principal place of business: Number and street City State Zip County The partnership is a limited partnership and the (a) address of its’ current registered office in this Commonwealth or (b) name of its commercial registered office provider and the county of venue is: (a) Number and Street City (b) Name of Commercial Registered Office Provider State Zip County County c/o: American LegalNet, Inc. www.FormsWorkFlow.com DSCB:15-8201B/8201C-2 3. Complete for Statement of Amendment Only: The amendment authorized by the partnership, set forth in full, is as follows: 4. Check boxes for Statement of Amendment Only: The restated Statement of Registration is set forth in full in Exhibit A, attached hereto and made a part hereof, and supersedes the original Statement of Registration and all previous amendments thereto. The amendment has been authorized by at least a majority in interest of the partners. 5. Check boxes for Statement of Termination Only: The registration of the partnership under the provisions of 15 Pa.C.S. § 8201 (relating to statement of termination) is hereby terminated. The termination has been authorized by at least a majority in interest of the partners. IN TESTIMONY WHEREOF, the undersigned general partner of the domestic registered limited liability partnership has executed this Statement of Amendment/Termination this day of , . Signature American LegalNet, Inc. www.FormsWorkFlow.com Department of State Bureau of Corporations and Charitable Organizations P.O. Box 8722 Harrisburg, PA 17105-8722 (717) 787-1057 web site: www.dos.state.pa.us/corps General Instructions for Completion of Form: A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit reproduction. The filing fee for this form is $70 made payable to the Department of State. B. A general partnership or a limited partnership may file a Statement of Amendment/Termination to amend its registration/terminate its status as a limited liability partnership. For a general partnership, the address need only be set forth in the first part of Paragraph 2. For a limited partnership, the address need only be set forth in the second part of Paragraph 2. Under 15 Pa.C.S. § 135(c) (relating to addresses) an actual street or rural route box number must be used as an address, and the Department of State is required to refuse to receive or file any document that sets forth only a post office box address. C. This form and all accompanying documents shall be mailed to the above stated address. Instructions for Amendment Only: E. The following, in addition to the filing fee, shall accompany this form: (1) If the amendment reflects a change of name, one copy of a completed form DSCB:15-134B (Docketing Statement-Changes). (2) If the amendment reflects a change of name of a general partnership, any necessary copies of form DSCB:17.2.3 (Consent to Appropriation of Name). (3) Any necessary governmental approvals. F. This form shall be executed by any general partner. G. This form shall be filed upon the occurrence of any of the following events: (1) A change in the name of the registered limited liability partnership. (2) A change in address of the registered limited liability partnership. A Statement of Registration for a domestic registered limited liability partnership may not be amended for any other purpose. H. If the address of the limited partnership which has registered as a registered limited liability limited partnership also changes, then a form DSCB:15-1507/4144/5507/6144/8506 (Statement of Change of Registered Office) must also be filed. American LegalNet, Inc. www.FormsWorkFlow.com