Articles Of Entity Conversion -- Conversion Of A Corporation Into A Limited Liability Company {51576}

ARTICLES OF ENTITY CONVERSION CONVERSION OF A CORPORATION INTO A LIMITED LIABILITY COMPANY State Form 51576 (R4 / 7-16) Approved by State Board of Accounts, 2016 SECRETARY OF STATE BUSINESS SERVICES DIVISION 302 West Washington Street, Room E018 Indianapolis, IN 46204 Telephone: (317) 232-6576 www.sos.in.gov INSTRUCTIONS: 1. Use 8 ½"x11 white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office on the web at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD. Name of business E-mail address of business (SOS use only) RETURN DOCUMENTS TO: Name Street address, line 1 Street address, line 2 City State ZIP code Telephone number E-mail address (If different from above ­ SOS use only) ( ) American LegalNet, Inc. www.FormsWorkFlow.com ARTICLES OF ENTITY CONVERSION CONVERSION OF A CORPORATION INTO A LIMITED LIABILITY COMPANY State Form 51576 (R4 / 7-16) Approved by State Board of Accounts, 2016 Indiana Code 23-1-18-3 FILING FEE: $30.00 ARTICLES OF CONVERSION OF ____________________________________________________________________________ (hereinafter "Non-surviving Corporation") INTO ____________________________________________________________________________ (hereinafter "Surviving LLC") ARTICLE I: PLAN OF ENTITY CONVERSION a. Please set forth the Plan of Conversion, containing such information as required by Indiana Code 23-1-38.5-11 and Indiana Code 23-138.5-12, attach herewith, and designate it as "Exhibit A." The following is basic information that must be included in the Plan of Entity Conversion: (please refer to Indiana Code 23-1-38.5-12 for a more complete listing of requirements before submitting the plan). A statement of the type of business entity that Surviving LLC will be and, if it will be a foreign non-corporation, its jurisdiction of organization; The terms and conditions of the conversion; The manner and basis of converting the shares of Non-surviving Corporation into the interests, securities, obligations, rights to acquire interests or other securities of Surviving LLC following its conversion; and The full text, as in effect immediately after the consummation of the conversion, of the organic document (if any) of Surviving LLC. If, as a result of the conversion, one or more shareholders of Non-surviving Corporation would be subject to owner liability for debts, obligations, or liabilities of any other person or entity, those shareholders must consent in writing to such liabilities in order for the Plan of Merger to be valid. Please read and sign the following statement. I hereby affirm under penalty of perjury that the plan of conversion is in accordance with the Articles of Incorporation or bylaws of Non-surviving Corporation and is duly authorized by the shareholders of Non-surviving Corporation as required by the laws of the State of Indiana. Printed Name Title b. Signature ARTICLE II: NAME AND DATE OF INCORPORATION OF NON-SURVIVING CORPORATION a. The name of Non-surviving Corporation immediately before filing these Articles of Entity Conversion is the following: b. The date on which Non-surviving Corporation was incorporated in the State of Indiana is the following (month, day, year): ARTICLE III: NAME AND PRINCIPLE OFFICE OF SURVIVING LLC a. The name of Surviving LLC is the following: (Please note pursuant to Indiana Code 23-18-2-8, this name must include the words "Limited Liability Company", "L.L.C.", or "LLC".) (If Surviving LLC is a foreign LLC, then its name must adhere to the laws of the state in which it is domiciled.) The address of Surviving LLC's Principal Office is the following: City State ZIP code b. Street Address (number and street) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com ARTICLE IV: REGISTERED OFFICE AND AGENT OF SURVIVING LLC Registered Agent: The name and street address of Surviving LLC's Registered Agent and Registered Office for service of process are the following: Name of Registered Agent Address of Registered Office (number and street or building) City State ZIP code Indiana ARTICLE V ­ JURISDICTION OF SURVIVING LLC AND CHARTER SURRENDER OF NON-SURVIVING CORPORATION SECTION 1: JURISDICTION Please state the jurisdiction in which Surviving LLC will be organized and governed. SECTION 2: CHARTER SURRENDER (Please complete this section only if Surviving LLC is organized outside of Indiana.) If the jurisdiction stated above is not Indiana, please set forth the Articles of Charter Surrender for the Non-surviving Corporation and attach herewith as "Exhibit B." Pursuant to Indiana Code 23-1-38.5-14, the Articles of Charter Surrender must include: 1. The name of Non-surviving Corporation; 2. A statement that the Articles of Charter Surrender are being filed in connection with the conversion of Non-surviving Corporation into an LLC that will be organized in a jurisdiction other than the State of Indiana; 3. A signed statement under penalty of perjury that the conversion was duly approved by the shareholders of Non-surviving Corporation in a manner required by Indiana Law and consistent with the Articles of Incorporation or the bylaws of Non-surviving Corporation; 4. The jurisdiction under which the Surviving LLC will be organized; and 5. The address of Surviving LLC's executive office. ARTICLE VI: DISSOLUTION OF SURVIVING LLC Please indicate when dissolution will take place in Surviving LLC: The latest date upon which Surviving LLC is to dissolve is _______________________________________, Surviving LLC is perpetual until dissolution. OR ARTICLE VII: MANAGEMENT OF SURVIVING LLC Surviving LLC will be managed by: The members of Surviving LLC, A manager or managers OR In Witness Whereof, the undersigned being an officer or other duly authorized representative of Non-surviving Corporation executes these Articles of Entity Conversion and verifies, subject to penalties of perjury, that the statements contained herein are true, this ____________________________ day of _________________________________, 20____________. Required: By checking the box, the Signator(s) represent(s) that the registered agent named in the application has consented to the appointment of registered agent. Signature Printed name Title Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com