Statement Of Division

Arizona Department of State Office of the Secretary of State , Secretary of State State of Arizona Office of the Secretary of State Statement of Division , A.R.S. 247 29 - 2605 SEND BY MAIL TO: Secretary of State , Atten: Limited Partnerships1700 W. Washington Street, FL. 7, Phoenix, AZ 85007-2808 O R return this application in person: PHOENIX - State Capitol Executive Tower, 1700 W. Washington Street, Fl., TUCSON - Arizona State Complex , 400 W. Congress , 1st Fl., Suite 14 1 Office Hours: Monday through Friday, 8 a.m. to 5 p.m., except state holidays. D O N OT W RITE IN T HIS S PACE FOR OFFICE USE ONLY SOSBS ARS292605 REV. //201 PLEASE NOTE: All correspondence regarding this filing will be sent to the principal office identified on this certificate. This application must be submitted with a self - addressed, stamped envelope with applicable filing fees. 1.Dividing entity information Dividing Entity Name Jurisdiction of Organization Secretary of State file number, if any Entity Type (select one) : Corporation Limited Liability Company Partnership Other: Statement of survival The dividing entity WILL survive the division The dividing entity will NOT survive the division 2. Resulting Entity Information Attach additional sheets should more resulting entities be needed Resulting Entity Name Jurisdiction of Organization Secretary of State file number, if any Resulting best known place of business in this state or street address in this state City State Zip Resulting Entity Type (select one) Corporation Limited Liability Company Partnership Other: Resulting Entity Name Jurisdiction of Organization Secretary of State file number, if any Resulting City State Zip Resulting Entity Type (select one) Corporation Limited Liability Company Partnership Other: Resulting Entity Name Jurisdiction of Organization Secretary of State file number, if any Resulting City State Zip Resulting Entity Type (select one) Corporation Limited Liability Company Partnership Other: Delayed effective date and time, if any , but not more than 90 days from date of receipt. See the instructions for further detail. 3.Agent for service of process of foreign non - required resulting entity Attach sheets for each additional agent Resulti Is a new statuatory agent being appointed? No Yes If yes, a signed statement of the statuatory agent accepting the appointment must be att ached to the Statement of Division . Arizona address of agent for service of process (P.O. Box or C/O are unacceptable) City State AZ Zip 4.Approved signature of dividing entity Name of Signer on behalf of dividing entity Statement of Division Approval This division was approved by this domestic or foreign dividing entity. [A.R.S. 247 29 - 2605(B)(5)] Signature Month Day Year Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Arizona Department of State Office of the Secretary of State , Secretary of State State of Arizona Office of the Secretary of State Statement of Division Instructions , A.R.S. 247 29 - 2605 SEND BY MAIL TO: Secretary of State , Atten: Limited Partnerships 1700 W. Washington Street, FL. 7, Phoenix, AZ 85007-2808 O R return this application in person: PHOENIX - State Capitol Executive Tower, 1700 W. Washington Street, Fl., TUCSON - Arizona State Complex , 400 W. Congress , 1st Fl., Suite 141 Office Hours: Monday through Friday, 8 a.m. to 5 p.m., except state holidays. DO NOT WRITE IN THIS SPACE FOR OFFICE USE ONLY SOSBS ARS292605 REV. //201 Instruction Be Accurate: Complete all applicable fields on this form. Write legibly; or fill out this application online at www.azsos.gov and print it. Processing: 2-3 weeks; expedited service ()available for an additional $25. Submission: Submit this certificate in duplicate (one original, one copy) with a self-addressed, stamped envelope with payment. Any other matters, please attach additional sheets with filing. Questions? Call (602) 542-6187; in-state/toll-free (800) 458-5842. Filing fee and Payment : $10 + $3 plus $3 per additional page. Checks or money orders shall be made payable to the Secretary of State. This fee is considered per entity name listed on the Statement of Division affect ing any entity(ies) recorded by our office , and not for filing the Statement of Division itself. For example, if the division indicates two entities recorded with our office, the filing fee will be, excluding additional pages, $26 (2 entities at $13 each) . Statuatory Obligation Arizona Revised Statutes (A.R.S.) 247247 29 - 26 01 2 6 07 provide reference for the creat ion of and recording of divisions . The requirements for this Statement of Division are set forth in A.R.S. 247 29 - 26 05. The filing of this form will affect all partnerships [limited partnership Statement of D ivision Effective Date If no effective date is specified and the filing meets all statutory requirements, the Secretary of State will deem the State ment to be effective on the date of delivery. Should a Statement have an effective date, it must be deliver ed to our office no more than 90 days will return the form and detail when the form should be resubmitted. Additional Steps/Requir ements Determine if any additional steps must take place. Our office will require additional paperwork , and subsequent fees , if the surviving entity will become a partnership recorded by our office. If additional paperwork and fees are not received, the e ntire request will be returned for resubmission. Option 1 : Statement of Division results in one or more new partnerships. The Statement of Division must be submitted with the appropriate registration form below, along with its filing fees. Option 2 : Statemen t of Division references an existing partner ship that will survive the division . Our office will process the Statement of Division as an amendment to the existing partnership on file. Option 3 : Statement of Division references a partnership that will not survive the division. Our office will process the Statement of Division as a cancellation to the existing partnership on file. LP Domestic Certificate of Limited Partnership No additional paperwork or fees required Foreign Foreign Limited Partnership Registration LLP Domestic Combined Certificate of Limited Partnership & Statement of Qualification to be a Limited Liability Partnership Foreign Statement of Qualification to be a Foreign Limited Liability Partnership LLLP Domestic Combined Certificate of Limited Partnership & Statement of Qualification to be a Limited Liability Partnership Foreign Statement of Qualification to be a Foreign Limited Liability Partnership Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com