Free Form - Nevada

ROSS MILLER Secretary of State 204 North Carson Street, Suite 1 Carson City, Nevada 89701-4520 (775) 684 5708 Website: www.nvsos.gov

Termination of Merger, Exchange or Conversion
(PURSUANT TO NRS CHAPTER 92A)
USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY

Certificate of Termination of Articles of Merger, Exchange or Conversion (Pursuant to NRS Chapter 92A)
1. The constituent entities, or in the case of conversion, the constituent and resulting entities are: ( if more than two entities, see article six )
Constituent Entity Constituent (or Resulting) Entity

2. Description of the original document filed: 3. Filing Date of the original document with the Nevada Secretary of State: 4. Effective Date, as specified, on the original document: 5. The aforementioned filing has been terminated pursuant to the plan. 6. If there are more than two entities attach an 8 1/2" x 11" blank sheet containing the name and authorized signature of each additional constituent entity and mark the following box. 7. Signatures: Must be signed by: An officer of each Nevada corporation; All general partners of each Nevada limited partnership; All managing partners of each Nevada limited-liability partnership; A manager of each Nevada limited-liability company with managers or one member if there are no managers; A trustee of each Nevada business trust. The articles of merger must be signed by each foreign constituent entity in the manner provided by the law governing it. (NRS 92A.230)
Name of Constituent Entity Date

X
Signature Title Name of Constituent (or Resulting) Entity Date

X
Signature Title

FILING FEE $350.00
IMPORTANT: Failure to include any of the above information and submit with the proper fees may cause this filing to be rejected.
This form must be accompanied by appropriate fees
Nevada Secretary of State 92A Termination Revised: 3-24-09

Reset