C
K
OMMONWEALTH OF
ENTUCKY
T
G
, S
S
REY
RAYSON
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Corporations
Cancellation of Foreign Statement of Qualification
FQC
Business Filings
(Foreign Limited Liability Partnership)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
_______________________________________________________________________________________
Pursuant to the provisions of KRS Chapter 362, the undersigned hereby cancels the registration on behalf of the limited
partnership named below and, for that purpose, submits the following statements:
1. Name of the foreign partnership on record with the Office of the Secretary of State is
_________________________________________________________________________________________.
(The name must be identical to the name on record with the Secretary of State.)
_________________
2. The date the Statement of Qualification was filed with the Office of the Secretary of State on
.
3. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date
____________.
or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is
(Delayed effective date
and/or time)
4. The limited liability partnership cancels its foreign statement of qualification.
We/I declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
__________________________________________________________________________________________
Signature of General Partner
Printed Name & Title
Date
__________________________________________________________________________________________
Signature of General Partner
Printed Name & Title
Date
(09/09)