MINNESOTA SECRETARY OF STATE STATEMENT OF DENIAL
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)
2. Partnership Name in Home Jurisdiction: (Only applies to foreign partnerships)
3. I hereby expressly deny the following fact(s):
In addition to the above, initial any of the following denials that also apply in your situation to which you wish to certify: I hereby expressly deny any and all statements asserted in the statement of partnership authority pertaining to the above named partnership. I hereby expressly deny any alleged status as a partner of the above named partnership. I hereby expressly deny the authority or status as a partner in the above named partnership of the following person (persons):
4. I acknowledge that this statement of denial is voluntary. I certify that I am authorized to sign this document 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.
Signature of Claimant
Daytime Telephone Number
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. 323A.0304 Statement of Denial, Minnesota Statutes, Chapter 323A.0304 A Statement of Denial is a limitation on authority as provided in Minnesota Statutes, Chapter 323A.0303(d) and (e).
1. List the name the partnership in Minnesota with respect to which this statement 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. This section provides you with the opportunity to deny ANY fact asserted in a statement of partnership authority, including denial of a person's status as a partner or of another person's authority as a partner. List the facts you wish to deny in the lined area provided, and/or initial any of the specific asserted denials that may directly apply to your individual situation and circumstances. Please provide an attachment if there is not enough room to complete this section. 4. The claimant who completes this statement of dissolution personally declares 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.