Form Dscb:15-8636 - Certificate Of Negation
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1
2PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Return document by mail to:
Name
Address
City
State
Zip Code
Return document by email to:
_________________________________
Read all instructions prior to completing.
Fee: $70
In compliance with the requirements of 15 Pa.C.S. § 8636 (relating to person erroneously believing self to be
limited partner), the undersigned person who erroneously but in good faith believed himself to be a limited partner, hereby
states that:
1. The name of the limited partnership is: ___________________________________________________________
2. The current registered office address as on file with the Department of State. Complete part (a) OR (b) – not both:
(a) _________________________________________________________________________________________________
Number and street
City
State
Zip
County
(b) c/o: ______________________________________________________________________________________________
Name of Commercial Registered Office Provider
County
3. The name of the person delivering this certificate to the Department for filing: ____________________________
4. The person named in paragraph 3 is not a general partner and withdraws from future participation as an owner in the
enterprise.
IN TESTIMONY WHEREOF, the undersigned person has caused this Certificate of Negation to be executed this
___________ day of ___________________________, 20
.
______________________________________________________________
Name of Person
______________________________________________________________
Signature
______________________________________________________________
Title
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Parent category: Legal