Free Cancellation of a Registered Name - Illinois

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LLC-45.20

Illinois Limited Liability Company Act

December 2004

Secretary of State Jesse White Department of Business Services Limited Liability Division 501 S. Second St., Rm. 351 Springfield, IL 62756 217-524-8008 www.cyberdriveillinois.com Payment may be made by business firm check payable to Secretary of State. If check is returned for any reason this filing will be void.

a) Application for Registration of Name b) Renewal of Registered Name c) Cancellation of Registered Name
SUBMIT IN DUPLICATE Must be typewritten
This space for use by Secretary of State.

FILE #
This space for use by Secretary of State.

Filing Fee: Approved:

a) $300 b) $100 c) $100

1. Limited Liability Company Name: __________________________________________________________________ ____________________________________________________________________________________________ 2. State or Country of Organization: ___________________________________________________________________ 3. Date of Organization: ____________________________________________________________________________ 4. Purpose for which the Limited Liability Company was organized: (Include Business Code # from IRS form 1065.)

5. Post Office Address to which notices may be mailed by the Secretary of State: _____________________________ ______________________________________________________________________________________________ 6. Federal Employer Identification Number (F.E.I.N.): _____________________________________________________ 7. The Limited Liability Company desires to register its name pursuant to Section 45-20, and it is NOT transacting business in the State of Illinois. 8. If the purpose of this submission is to register a name or to renew a registered name, a certificate not more than 30 days old must be attached stating that the Limited Liability Company is in good standing under the laws of the state or country wherein it is organized. 9. Such registration or renewal of registration shall be effective from the date of filing by the Secretary of State until the first day of the 12th month following such date. 10. The cancellation shall be effective upon filing with the Secretary of State. 11. The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this application is to the best of my knowledge and belief, true, correct and complete. Dated ________________________________ , _________

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Signature

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Name and Title (type or print)

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If applicant is a Company or other Entity, state Name of Company and indicate whether it is a member or manager of the LLC. Printed by authority of the State of Illinois. April 2007 -- 1M -- LLC-6.4