Free STATE OF MINNESOTA SECRETARY OF STATE ARTICLES OF INCORPORATION Business and Nonprofit Corporations - Minnesota

MINNESOTA SECRETARY OF STATE STATEMENT OF AMENDMENT or CANCELLATION
Minnesota Statutes, Chapter 323A Fee: $135.00
READ THE INSTRUCTIONS BEFORE COMPLETING THIS FORM

A person who files a statement pursuant to this section shall promptly send a copy of the statement to every non-filing partner and to any other person named as a partner in the statement. 1. Limited Liability Partnership Name used in Minnesota: (Required)

For your convenience, this form has been designed to be completed online. You must have Acrobat Reader 7.0 or above to use this new feature. Once your form is completed, be sure to select "Print" at the bottom of the screen to capture your data entry for printing. After printing, sign and send applicable fees as required. Note: Selecting "Reset" will clear all data entry from this page. To print a blank form, go to File->Print.

2. Partnership Name in Home Jurisdiction: (Only applies to foreign partnerships)

3. Identify the statement below this amendment or cancellation pertains to: (Check ONE box only) Statement of Partnership Authority Statement of Dissolution Statement of Merger Statement of Dissociation Statement of Denial Limited Liability Partnership Statement 4. State the substance of your amendment OR cancellation in the box provided: (NOTE: Use an additional sheet if needed)

5. I acknowledge that this statement of amendment OR cancellation is voluntary. I certify that I am a partner authorized to sign this document on my behalf, or on behalf of this partnership and I further certify that by signing this document I am subject to the penalties of perjury as set forth in Minnesota Statutes, section 609.48 as if I had signed this document under oath. Note that this statement must be signed by at least two (2) partners, if it pertains to a statement filed on behalf of the partnership (i.e. merger, dissolution, partnership authority).

Signature of a Partner

Signature of a Partner

Print Name

Print Name

Daytime Telephone Number

Daytime Telephone Number

Print

Reset Form

Statementofamendmentcancellation.docRev.9-08

INSTRUCTIONS
THIS AMENDMENT MUST BE TYPED OR LEGIBLY PRINTED IN BLACK INK ONLY.

NOTE: This form is intended merely as a guide for filing and is not intended to cover all situations. A person who files a statement pursuant to this section shall promptly send a copy of the statement to every non-filing partner and to any other person named as a partner in the statement.

1. List the name the partnership in Minnesota with respect to which this amendment or cancellation is filed. 2. If applicable, list the limited liability partnership name used in the Home Jurisdiction. This would only apply for foreign partnerships that are using an alternate name if Minnesota. 3. Check the box which identifies the statement with respect to which this amendment or cancellation is filed. Only check ONE box. 4. State your specific amendment OR cancellation in the box provided. Please provide an attachment if there is not enough room to complete this section. 5. If this document is being filed on behalf of the partnership, it must be signed by at least two partners who are authorized to sign the registration. Individuals and partners who complete this statement of amendment or cancellation personally declare under penalty of perjury that the contents of the statement are accurate.

Filing Fee: $135.00 Payable to the MN Secretary of State

FILE IN-PERSON OR MAIL TO: Minnesota Secretary of State - Business Services Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St Paul, MN 55103 (Staffed 8:00 - 4:00, Monday - Friday, excluding holidays)

To obtain a copy of a form you can go to our web site at www.sos.state.mn.us , or contact us between 9:00am to 4:00pm, Monday through Friday at (651) 296-2803 or toll free 1-877-551-6767.

All of the information on this form is public. Minnesota law requires certain information to be provided for this type of filing. If that information is not included, your document may be returned unfiled. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service.