Withdrawal Statement {CR2E140}

COVER LETTER TO: Registration Section Division of Corporations SUBJECT: Name of Limited Liability Company Dear Sir or Madam: The enclosed Withdrawal Statement and fee(s) are submitted for filing. Please return all correspondence concerning this matter to the following: Name of Person Firm/Company Address City/State and Zip Code E-mail address: (to be used for future annual report notification) For further information concerning this matter, please call: at ( Name of Person Area Code ) Daytime Telephone Number STREET/COURIER ADDRESS: Registration Section Division of Corporations Clifton Building 2661 Executive Center Circle MAILING ADDRESS: Registration Section Division of Corporations P.O. Box 6327 Tallahassee, Florida 32314 CR2E140 (2/14) American LegalNet, Inc. www.FormsWorkFlow.com WITHDRAWAL STATEMENT Pursuant to section 605.0208, Florida Statutes, I hereby submit the following withdrawal statement withdrawing a record before it takes effect: FIRST: The name of the limited liability company is: SECOND: The Florida Document number of the limited liability company is: THIRD: The record to be withdrawn is: FOURTH: Please check the appropriate box This withdrawal statement is signed by all the persons who signed the record being withdrawn. or This record is withdrawn in accordance with the agreement of all the persons who signed the record. Signature of person submitting withdrawal Typed or printed name of signature Signature of person submitting withdrawal Typed or printed name of signature Signature of person submitting withdrawal Typed or printed name of signature Signature of person submitting withdrawal Typed or printed name of signature Filing fee: $25.00 Certified Copy: $30.00 (optional) CR2E140 (2/14) American LegalNet, Inc. www.FormsWorkFlow.com