State of Utah DEPARTMENT OF COMMERCE Division of Corporations & Commercial Code Articles of Conversion 1. The articles of conversion shall state: First: The date and state where the subject entity was first created and, if it has changed, its jurisdiction immediately prior to its conversion; _______________________________ Date _______________________________ State / Jurisdiction Second: The name of the subject entity immediately prior to the filing of the articles of conversion; ______________________________________________________________________________________ Third: The name of the entity as set forth in its converted entity filing; ______________________________________________________________________________________ Fourth: The future effective date of the conversion to the new entity if it is not to be effective upon the filing of the articles of conversion; ______________________________________________________________________________________ Fifth: Under penalties of perjury, I declare that the articles of conversion have been duly approved by the owners of the entity. Dated ___________________________, 20____ By:____________________________________________________________ 2. Additional filing requirements: The non-refundable processing fee of $37.00 payable to the State of Utah. You may file in person, by mail, or fax. Means of payment are, cash, check, or money order made payable to the "State of Utah". If you are faxing you must include, on a cover sheet, the number of a Visa, MasterCard or American Express with the date of expiration. Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity. Mailing/Faxing Information: www.corporations.utah.gov/contactus.html Division's Website: www.corporations.utah.gov American LegalNet, Inc. www.FormsWorkflow.com