Limited Liability Company Certificate Of Cancellation - Washington Secretary Of State Page 2

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SECTION 6
REASON FOR CANCELLATION:
(if necessary, attach additional information)
SECTION 7
MEMBER OR MANAGER SIGNATURE
(see instructions page)
This document is hereby executed under penalties of perjury, and is, to the best of my knowledge, true and correct.
X_______________________________________________________________________________________
Signature
Printed Name/Title
Date
Phone
RCW 25.15.080
Cancellation of certificate
A certificate of formation shall be canceled upon the effective date of the certificate of cancellation, or as provided in RCW 25.15.290, or
upon the filing of articles of merger if the limited liability company is not the surviving or resulting entity in a merger. A certificate of
cancellation shall be filed in the office of the secretary of state to accomplish the cancellation of a certificate of formation upon the
dissolution and the completion of winding up of a limited liability company and shall set forth:
(1) The name of the limited liability company;
(2) The date of filing of its certificate of formation;
(3) The reason for filing the certificate of cancellation;
(4) The future effective date (which shall be a date not later than the ninetieth day after the date it is filed) of cancellation if it is not to
be effective upon the filing of the certificate; and
(5) Any other information the person filing the certificate of cancellation determines.
[1994 c 211 § 203.]
LLC - Cancellation
Washington Secretary of State
Revised 02/09

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