Certificate Of Conversion From A Non-Delaware Limited Liability Company To A Delaware Limited Liability Company - Delaware Division Of Corporations Page 2

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STATE OF DELAWARE
CERTIFICATE OF CONVERSION
FROM A NON-DELAWARE LIMITED LIABILITY COMPANY TO
A DELAWARE LIMITED LIABILITY COMPANY PURSUANT TO
SECTION 18-214 OF THE LIMITED LIABILITY ACT
1.) The jurisdiction where the Non-Delaware Limited Liability Company first
formed is____________________________________________________.
2.) The jurisdiction immediately prior to filing this Certificate is________________.
3.) The date the Non-Delaware Limited Liability Comp
any first formed is
__________________________________________
.
4.) The name of the Non-Delaware Limited Liability Company immediately prior to
filing this Certificate is______________________________________________.
5.) The name of the Limited Liability Company as set forth in the Certificate of
Formation is _____________________________________________________.
IN WITNESS WHEREOF, the undersigned have executed this Certificate on the
___________day of _________________, A.D._______________.
By:____________________________
Authorized Person
Name:____________________________
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