Free CV.p65 - Kansas

Contact Information
Kansas Secretary of State Ron Thornburgh Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594
(785) 296-4564
[email protected]
www.kssos.org


KANSAS SECRETARY OF STATE


Certificate of Conversion
All information must be completed or this document will not be accepted for filing.

CV

53-14

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A general partnership, limited liability partnership (LLP), limited partnership (LP), limited liability limited partnership(LLLP), business trust/association, real estate investment trust, common-law trust, foreign limited liability company, or any other unincorporated business may convert to a Kansas LLC by certifying the following information: 1. Date and jurisdiction where the entity was formed, and, if the jurisdiction has changed, the jurisdiction immediately prior to this conversion:

Please complete the form, print, sign and mail to the Kansas Secretary of State with the filing fee. Selecting 'Print' will print the form and 'Reset' will clear the entire form.
Do not write in this space

___________________________________________________________________________________________________________ 2. Name of the converting entity: ___________________________________________________________________________________________________________

3. Future effective date of conversion if not effective upon filing, but not later than 90 days after the filing date: _________________
Month

____________
Day

___________
Year

4. Name of limited liability company: 5. This conversion was approved pursuant to the document, instrument, agreement or other writing governing the internal affairs of the converting entity and the conduct of its business or by applicable law.

I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on the ________ of ___________ , _____________ .
Day Month Year

Authorized person

Instructions 1. Submit this form with the $35 filing fee. 2. Attach articles of organization for the new LLC, form DL, with the $165 filing fee.
Notice: There is a $25 service fee for all returned checks.

Rev. 12/08/04 amc Rev. 8/11/03 jls K.S.A. 17-7684