Free ss-4232.indd - Tennessee

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Corporate Filings 312 Rosa L. Parks Avenue 6th Floor, William R. Snodgrass Tower Nashville, TN 37243

CERTIFICATE OF FORMATION (LIMITED LIABILITY COMPANY)

Pursuant to the provisions of §48-203-102 of the Tennessee Limited Liability Company Act or §48-249201 of the Tennessee Revised Limited Liability Company Act, the undersigned hereby submits the following statement.

1. The Limited Liability Company was formed and the date of formation is (month, day and year)

.

Signature Date

Name of Limited Liability Company

Signer's Capacity

Signature

Name (typed or printed)

SS-4232 (Rev. 01/06)

Filing Fee: $20

RDA 2458