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DSCB: 15-1954/5954

Department of State

Bureau of Corporations and Charitable Organizations

P.O. Box 8722

Harrisburg, PA 17105-8722

(717) 787-1057

web site:

Instructions for Completion of Form:

A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit reproduction.

The filing fee for this form is $195 plus $125 additional for each new corporation/limited partnership/limited liability company

in excess of one resulting from the division, made payable to the Commonwealth of Pennsylvania. Checks must contain a

commercially pre-printed name and address.

and the

Department of State is required to refuse to receive or file any document that sets forth only a post office box address.

C. The following, in addition to the filing fee, shall accompany this form:

(1) Two copies of a completed form DSCB:15-134B (Docketing Statement-Changes).

(2) Business/Nonprofit Corporation Only: One copy of a separate completed form DSCB:15-134A (Docketing

Statement), with respect to each new corporation resulting from the division, unless the new corporation is a

nonqualified foreign corporation.

(3) Any necessary copies of form DSCB:17.2.3 (Consent to Appropriation of Name). A change in name of

a surviving corporation/limited partnership/limited liability company shall contain a statement of the complete new

name.

(4) Any necessary governmental approvals.

(5) Tax clearance certificates are required from the Department of Revenue and the Bureau of Employment security of

the Department of Labor and Industry as described in Instruction G.

D. The second alternate of Paragraph 5 is not applicable unless at least two new corporations/limited partnerships/limited liability

companies result from the division.

E. A completed form DSCB:15-1306/2102/2303/2702/2903/3101/7102A (Articles of Incorporation-For Profit)/DSCB:15-5306

(Articles of Incorporation-Nonprofit)/DSCB:15-8511 (Certificate of Limited Partnership)/DSCB:15-8913 (Certificate of

Organization) should be attached to the plan of division with respect to each new domestic business/nonprofit

corporation/limited partnership/limited liability company resulting from the division. It is not necessary to execute such articles

of Incorporation/Certificate of Limited Partnership/Certificate of Organization and an additional fee or fees relating the form

should not be tendered.

F. A foreign business/nonprofit corporation/limited partnership/limited liability company may effect a division resulting in one or

more new domestic business/nonprofit corporations/limited partnerships/limited liability companies notwithstanding the fact

that such foreign business/nonprofit corporation/limited partnership/limited liability company has not received a certificate of

authority/application for registration to do business in Pennsylvania.

G. If the dividing corporation/limited partnership/limited liability company will not survive the division and is a domestic

business/nonprofit corporation/limited partnership/limited liability company or a qualified foreign business/nonprofit

Articles/certificate Of Division - Bureau Of Corporations And Charitable Organizations - Pennsylvania Department Of State Page 4