State of Missouri
D WE S T ITE
This form is designed to be filled out online for your convenience. Please read the instructions carefully. Complete the necessary information, print, sign and mail.
Print Reset
D AN
DIV
Robin Carnahan, Secretary of State
X ESTO LE
ED WE FA ID
E PL
URI B
UM N U
SALUS
PO
MDC
PUL
I SUPREM
CCXX
1. The name of the limited liability company is 2. The articles of organization for the limited liability company were filed on the following date
3. Persons with claims against the limited liability company should present them in accordance with the following procedure: A. In order to file a claim with the limited liability company, you must furnish the following: i. Amount of the claim ii. Basis for the claim iii. Documentation of the claim B. Claims must be mailed to:
Name
Street Address
City/State/Zip
4. A claim against the limited liability company will be barred unless a proceeding to enforce the claim is commenced within three years after the publication of the notice.
In Affirmation thereof, the facts stated above are true and correct: (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo)
Authorized Signature
Authorized Signature
Authorized Signature
Name and address to return filed document: Name: Address: City, State, and Zip Code:
LLC-13 (11/2008)
LL
US
A
Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102
UN
Notice of Winding Up for Limited Liability Company
(Submit with filing fee of $25.00)
Charter #:
Month/Day/Year
Printed Name
Date
Printed Name
Date
Printed Name
Date