Articles Of Conversion {LP 1104}

Print Form Reset Save LP 1104 August 2012 Secretary of State Department of Business Services Limited Liability Division 501 S. Second St., Rm. 357 Springfield, IL 62756 217-524-8008 www.cyberdriveillinois.com Payment may be made by check payable to Secretary of State. If check is returned for any reason this filing will be void. Please do not send cash. Illinois Uniform Limited Partnership Act FILE # This space for use by Secretary of State. Articles of Conversion SUBMITINDUPLICATE Please type or print clearly. Filing Fee: $50 Approved: The following entity has been converted into another organization in accordance with Article 11, Section 11021105, of the Uniform Limited Partnership Act (2001). 1. Converting Organization Name:____________________________________________________________ 2. File Number, if applicable: ________________________________________________________________ 3. Name of Entity after conversion: __________________________________________________________ Type of Entity: ________________________________ Jurisdiction: ____________________________ 4. Street and mailing address of Survivor: ______________________________________________________ Street Address ____________________________________________________________________________________________________________________ City, State, ZIP 5. Effective Date of Conversion: o __________________________________filing date o a later date, but not more than 30 days in the future: ________________________________________ Date (month, day, year) This conversion meets the requirements of the Uniform Limited Partnership Act (2001), effective Jan. 1, 2005, and has been approved as required by the governing statutes of the converted organization. *If required, this statement is accompanied by the organizational document of the converted organization. Printed on recycled paper. Printed by authority of the State of Illinois. March 2013 -- 1 -- CLP 26.4 American LegalNet, Inc. www.FormsWorkFlow.com Form LP 1104 The original Articles of Conversion must be signed by all General Partners. The undersigned affirms, under penalties of perjury, that the facts stated herein are true. 1. Dated: ___________________________________ Month, Day, Year 2. Dated: __________________________________ Month, Day, Year ________________________________________ Signature ________________________________________ Signature ________________________________________ Name and Title (type or print) ________________________________________ Name and Title (type or print) ________________________________________ General Partner Name if corporation or other entity ________________________________________ General Partner Name if corporation or other entity 3. Dated: ___________________________________ Month, Day, Year 4. Dated: __________________________________ Month, Day, Year ________________________________________ Signature ________________________________________ Signature ________________________________________ Name and Title (type or print) ________________________________________ Name and Title (type or print) ________________________________________ General Partner Name if corporation or other entity ________________________________________ General Partner Name if corporation or other entity Signatures must be in black ink on an original document. Carbon copy, photocopy or rubber stamp signatures may only be used on conformed copies. American LegalNet, Inc. www.FormsWorkFlow.com