COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION UPA-137 (04/06) STATEMENT OF CANCELLATION OF A STATEMENT OF REGISTRATION OF A DOMESTIC REGISTERED LIMITED LIABILITY PARTNERSHIP The undersigned present(s) this statement for filing pursuant to § 50-73.137 of the Code of Virginia. 1. The name of the registered limited liability partnership is _____________________________________________________________________________ _____________________________________________________________________________. 2. The initial statement of registration was filed in Virginia on _________________________________. (month, day, year) 3. Additional information (if any): ____________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________. 4. The cancellation of the registration of this partnership as a registered limited liability partnership is consented to by all partners in the partnership at the time this statement is filed. The undersigned individual(s) personally declare(s) under penalty of perjury that the contents of this statement are accurate. Signatures of at least two partners of a partnership or one or more authorized general partners of a limited partnership: _________________________ __________________________ (signature) ______________ _________ (printed name) _________________________ (title) __________________________ (signature) ______________ _________ (printed name) __________________________________________ (registered limited liability partnership’s SCC ID no.) (date) (title) (date) _____________________________ (telephone number (optional)) SEE INSTRUCTIONS ON THE REVERSE Provide a name and mailing address for sending correspondence regarding the filing of this document. (If left blank, correspondence will be sent to the registered agent at the registered office.) (name) (mailing address) American LegalNet, Inc. www.USCourtForms.com INSTRUCTIONS Section 50-73.83 of the Code of Virginia requires that this statement be in the English language, typewritten or printed in black, legible and reproducible. The document must be presented on uniformly white, opaque paper, free of visible watermarks and background logos. You can download this form from our website at www.scc.virginia.gov/division/clk/fee_bus.htm. Each person signing this statement must set forth his or her printed name next to or beneath his or her signature. A person signing on behalf of a partner that is a business entity should set forth the business entity’s name, his or her printed name, and the capacity in which he or she is signing on behalf of the business entity. See § 50-73.83 C of the Code of Virginia. The filing of a statement of cancellation of a registered limited liability partnership by or on behalf of a partnership pursuant to § 50-73.137 of the Code of Virginia shall be effective only to cancel the partnership’s registration as a registered limited liability partnership, and shall not, unless it is specifically so provides, indicate the dissolution of the partnership. The person who files this statement must promptly send a copy of the statement to every nonfiling partner and to any other person named as a partner in the statement. See § 50-73.83 E of the Code of Virginia. Submit the original, signed statement to the Clerk of the State Corporation Commission, P.O. Box 1197, Richmond, Virginia 23218-1197, (Street address: 1300 East Main Street, Tyler Building, 1st Floor, Richmond, Virginia 23219), along with a check for the filing fee in the amount of $25.00 payable to the State Corporation Commission. PLEASE DO NOT SEND CASH. If you have any questions, please call (804) 371-9733 or toll-free in Virginia, 1-866-722-2551. NOTE A statement of cancellation (or judicial decree of cancellation) is effective when accepted for filing by the Commission, unless otherwise provided in the Virginia Uniform Partnership Act or in the statement. If a delayed effective date is desired, set forth the date in paragraph 3. A delayed effective date must be a date certain on or after the date the statement of cancellation is filed. See § 50-73.137 of the Code of Virginia. American LegalNet, Inc. www.USCourtForms.com