Form Ll:0009 - Certificate Of Cancellation Of Application For Registration (Page 2 of 2) in pdf

Form Ll:0009 - Certificate Of Cancellation Of Application For Registration Page 2

CERTIFICATE OF CANCELLATION OF

APPLICATION FOR REGISTRATION

Pursuant to A.R.S. § 29-808

1. The name of the foreign limited liability company is:

___________________________________________________________________________.

2. The company was formed under the laws of the State of ______________________

3. The cancellation does not terminate the authority of the commission to accept service of

process on the foreign limited liability company with respect to causes of action arising

out of the transactions of business in this state.

4. The address of the organization in its jurisdiction to which the Arizona Corporation

Commission can forward service of process is:

_____________________________________________________________________

____________________________________________________________________

_____________________________________________________________________

Dated this

day of

Signature:

_________________________________________________

(Check one)

Member

Manager

Authorized

Agent

Print Name:

_______________________________________________

__________________________________________________________

If signing on behalf of a company, please print company name here.

LL:0009

Arizona Corporation Commission

Rev: 10/2006

Corporations Division

Form Ll:0009 - Certificate Of Cancellation Of Application For Registration Page 2