Free ss-4268.indd - Tennessee


File Size: 21.4 kB
Pages: 1
Date: June 28, 2007
File Format: PDF
State: Tennessee
Category: Secretary of State
Author: ie21mdw
Word Count: 191 Words, 1,243 Characters
Page Size: Letter (8 1/2" x 11")
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http://state.tn.us/sos/forms/ss-4268.pdf

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CERTIFICATE OF CONVERSION (Another Business Entity into LLC)
Corporate Filings 312 Eighth Avenue North 6th Floor, William R. Snodgrass Tower Nashville, TN 37243

Pursuant to the provisions of ยง48-249-703 of the Tennessee Revised Limited Liability Company Act, the undersigned Limited Liability Company hereby submits this certificate of conversion: 1. The name of the domestic limited liability company as set forth in its articles of organization is: . 2. The name of the converting other business entity immediately prior to the filing of the certificate of conversion is: .

3. The jurisdiction in which the converting other business entity was formed is its date of formation is . 4. All required approvals of the conversion have been obtained by the other business entity.

,

(month/day/year), and its business type is a

5. If the conversion is not to be effective upon the filing of the certificate of conversion and articles of organization, then the future effective date or time of the conversion to a domestic LLC is: Date:______________________ , _______________ Time ___________________

Signature date

Signature

Signer's capacity

Name (typed or printed)

SS-4268 (Rev. 06/07)

Filing Fee $20

RDA 2458