State Form 51577 - Articles Of Entity Conversion - Indiana Limited Liability Company - 2016

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ARTICLES OF ENTITY CONVERSION
SECRETARY OF STATE
CONVERSION OF AN INDIANA NON-CORPORATION
BUSINESS SERVICES DIVISION
302 West Washington Street, Room E018
BUSINESS ENTITY INTO AN INDIANA LIMITED LIABILITY
Indianapolis, IN 46204
COMPANY
Telephone: (317) 232-6576
State Form 51577 (R4 / 7-16)
Approved by State Board of Accounts, 2016
INSTRUCTIONS:
1. Use 8 ½”x11 white paper for attachments.
2. Please TYPE or PRINT in INK.
3. Please visit our office on the web at
4. Make check or money order payable to the Secretary of State.
5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204.
INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD.
Name of business
E-mail address of business (SOS use only)
RETURN DOCUMENTS TO:
Name
Street address, line 1
Street address, line 2
City
State
ZIP code
Telephone number
E-mail address (If different from above – SOS use only)
(
)

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