Form L-01a - Articles Of Organization Including Articles Of Conversion Page 3

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12.
These articles will be effective upon filing, unless a future date is specified: _____________________.
This is the____ day of _______________, 20______.
____________________________________
(Optional: Business Entity Name)
____________________________________
Signature
____________________________________
Type or Print Name and Title
The below space to be used if more than one organizer or member is listed in Item #5 above.
(Optional: Business Entity Name)
(Optional: Business Entity Name)
________________________________ __
Signature
Signature
__________________________________
___________________________________
Type or Print Name and Title
Type or Print Name and Title
(Optional: Business Entity Name)
(Optional: Business Entity Name)
________________________________ __
Signature
Signature
__________________________________
___________________________________
Type or Print Name and Title
Type or Print Name and Title
NOTES:
1.
Filing fee is $125. This document must be filed with the Secretary of State.
CORPORATIONS DIVISION
P.O. BOX 29622
RALEIGH, NC 27626-0622
(Revised January 2014)
Page 3
(Form L-01A)

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