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Form Llc-4/7 - Limited Liability Company Certificate Of Cancellation - State Of California Secretary Of State

State of California

Kevin Shelley

Secretary of State

LIMITED LIABILITY COMPANY

CERTIFICATE OF CANCELLATION

There is no fee for filing the Certificate of Cancellation with the Secretary of State.

IMPORTANT – Read instructions before completing this form.

NOTE: This Certificate of Cancellation (LLC-4/7) must be filed in order to cancel

your Articles of Organization or Application for Registration and your

liability for any tax as a limited liability company. A tax clearance

certificate is required.

This Space For Filing Use Only

2. Name of

Secretary of State File Number

Limited Liability Company Name

3. It is hereby certified that this limited liability company cancels its (check one):

[ ]

Articles of Organization pursuant to Subdivision (b) of Section 17356 of the California Corporations Code.

[ ]

Registration pursuant to Section 17455 of the California Corporations Code.

4. The tax liability will be satisfied on a taxes paid basis or that a person, limited liability company, or other business entity

assumes the tax liability, if any, of the dissolving limited liability company as security for the issuance of a tax clearance

certificate from the Franchise Tax Board and is responsible for additional taxes or fees, if any, that are assessed under the

Revenue and Taxation Code and become due after the date of the assumption of tax liability. (DO NOT ALTER THIS

STATEMENT)

5. DOMESTIC ONLY

The separate filing of the Certificate of Dissolution (LLC-3) pursuant to Section 17356 is not required, because

dissolution pursuant to Section 17350 is made by a vote of all of the members.

[ ] YES

[ ] NO

6. Other information the managers or members filing the Certificate of Cancellation of Articles of Organization or

Application for Registration determine to include. (Attach additional pages, if necessary).

7. Number of pages attached, if any:

8. It is hereby declared that I am the person who executed this instrument, which execution is my act and deed.

Signature of Authorized Person

Type or Print Name and Title of Authorized Person

Date

9. RETURN TO:

NAME

FIRM

ADDRESS

CITY/STATE

ZIP CODE

SEC/STATE (REV. 01/03)

FORM LLC-4/7 – NO FILING FEE

Approved by Secretary of State

Form Llc-4/7 - Limited Liability Company Certificate Of Cancellation - State Of California Secretary Of State

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