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Sec. 178.40 Wis. Stats.

State of Wisconsin DEPARTMENT OF FINANCIAL INSTITUTIONS Division of Corporate & Consumer Services

DOMESTIC OR FOREIGN LIMITED LIABILITY PARTNERSHIP NOTICE OF WITHDRAWAL
1. Name of the registered limited liability partnership (If the partnership is registered under a fictitious name, provide the fictitious name):

2. Select and mark (X) the appropriate choice below:

! The partnership is formed under the laws of Wisconsin.
OR

! The partnership is a foreign limited liability partnership, formed and registered under the
laws of the state of 3. The limited liability partnership withdraws its registration. 4. (Partner's signature) (Date executed) (Typed or printed name) (Partner's signature) (Typed or printed name) .

(See instructions for authorized signatures)

This document was drafted by (Name the individual who drafted the document) __________________________________________________________________________________ FILING FEE - $40.00 See instructions, suggestions, and procedures on following pages. DFI/CORP/624(R06/30/09) Use of this form is mandatory. 1 of 2
(Earlier editions, 1996 or later, may be used)

DOMESTIC OR FOREIGN LIMITED LIABILITY PARTNERSHIP NOTICE OF WITHDRAWAL



Your name, return address and phone number during the day:

(

)

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INSTRUCTIONS (Ref. sec. 178.40, Wis. Stats. for document content) Submit one original and one exact copy to Department of Financial Institutions, P O Box 7846, Madison WI, 53707-7846, together with a FILING FEE of $40.00, payable to the department. Filing fee is non-refundable. (If sent by Express or Priority U.S. mail, address to 345 W. Washington Ave., 3rd Floor, Madison WI, 53703). Sign the document manually or otherwise as allowed under sec. 178.46 (1g) (d). NOTICE: This form may be used to accomplish a filing required or permitted by statute to be made with the department. Information requested may be used for secondary purposes. If you have any questions, please contact the Division of Corporate & Consumer Services at 608-2617577. Hearing-impaired may call 608-266-8818 for TTY. This document can be made available in alternate formats upon request to qualifying individuals with disabilities. 1. Enter the name of the limited liability partnership as it is presently registered with the Department of Financial Institutions. If the partnership is registered under a fictitious name, indicate the fictitious name. 2. Indicate if the limited liability partnership is formed under the laws of Wisconsin, or if not, the state under whose laws it is formed. 3. This is the statement prescribed under sec. 178.40 (3) (c). 4. The document is to be executed by one or more partners authorized by the partnership, or as otherwise provided in the partnership agreement. Sec. 182.01(3) provides that the statement shall not be filed unless the name of the person (individual) who drafted it is printed, typewritten or stamped thereon in a legible manner. If the document is not executed in Wisconsin, enter that remark. Filing a notice of withdrawal does not satisfy a partnership's obligation to file a Final Return with tax authorities, if a return is due. For particulars, contact WI Dept of Revenue at (608) 266-0800 or http://www.revenue.wi.gov/html/taxcorp.html.

DFI/CORP/624I(R06/30/09)

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