Form Be-16 - Articles Of Conversion Page 2
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1
2nstructions for Filing
I
ARTICLES OF CONVERSION
(Form AC-1)
This form should only be used by a domestic business entity for the purpose of converting to a foreign business entity that is
not authorized to transact business or conduct affairs in this state. If the domestic business entity is converting to a business
entity whose formation or whose status as a registered liability partnership, as defined in G.S. 59-32, or limited liability
partnership, as defined in G.S. 59-102, requires the filing of a document with the Secretary of State, then the articles of
conversion shall be included as part of that document instead of separately filing the articles of conversion.
Item 1
Enter the complete name of the converting business entity.
Item 2.
State whether the converting business entity is a domestic corporation, limited liability company, limited partnership,
registered limited liability partnership or domestic partnership.
Item 3
Enter the name of the resulting business entity.
Item 4
State whether the resulting business entity is a foreign corporation, limited liability company, limited partnership, limited
liability partnership or foreign partnership.
Item 5
Enter the name of the state or country whose laws govern the resulting business entity’s organization and internal affairs.
(Note, this cannot be North Carolina.)
Item 6
Enter the mailing address of the resulting business entity.
Item 7
See form.
Item 8
The document will be effective on the date and at the time of filing, unless a delayed date or an effective time (on the day
of filing) is specified. If a delayed effective date is specified without a time, the document will be effective at 11:59:59
p.m. on the day specified. If a delayed effective date is specified with a time, the document will be effective on the day and
th
time so specified. A delayed effective date may be specified up to and including the 90
day after the day of filing.
Date and Execution
Enter the date the document was executed.
In the blanks provided enter:
•
The name of the business entity executing the Articles of Conversion.
•
The signature of the representative of the converting business entity.
•
The name and title of the above signed representative
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622
(Revised January, 2002)
(Form BE-16)
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