Free Microsoft Word - SOS Partnership Form FS 0730 Statement of Merger - Mississippi

MISSISSIPPI SECRETARY OF STATE POST OFFICE BOX 136 JACKSON, MISSISSIPPI 39205-0136 CUSTOMER SERVICE 601-359-1633 www.sos.state.ms.us
HTU UTH

STATEMENT OF MERGER
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Filing Fee $25.00. Type or print legibly in blue or black ink. Please do not highlight or write above this line.

1. Name of Domestics partnership and other entities that are a party to the merger; including entity types. (partnerships, limited partnerships, corporations etc):
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Name of Domestic Partnership

Name of other entity

Entity Type

Name of other entity

Entity Type

Name of other entity 2. Domicile of surviving entity and entity type
U U

Entity Type

Name of Surviving Entity 3. Street Address of Chief Executive Office:
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Entity Type

Street Address

City

State

Zip Code

4.

Street Address of one Office Located in Mississippi, if any:
U U U U

Street Address

City

State

Zip Code

5. Continuing Sections:
(to continue information from any section, mark box and follow instructions) Page(s) Attached To continue information from any section(s) of this form, please: 1. Mark the box at the left. 2. Attach plain 8 ½" x 11" paper and specify which section(s) are being continued.

6. Signatures: (must be
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executed by at least 2 partners)(to continue on another page...see section 6)

I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF MISSISSIPPI THAT THE FOREGOING IS TRUE AND CORRECT OF MY OWN KNOWLEDGE.

____________________________________________ Partner Signature

____________________________________________ Title

____________________________________________ Print Name

____________________________________________ Partner Signature

____________________________________________ Title

____________________________________________ Print Name Submit completed form along with the filing fee of $25.00 to Mississippi Secretary of State, Business Services Division, Post Office Box 136, Jackson, Mississippi 39205-0136.

Effective Date: January 1, 2007

SOS PARTNERSHIP FORM FS 0730