PENNSYLVANIA 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
Caution: This form does not end the existence of the general partnership or remove the general partnership from the rolls
of active associations in the records of the Department. Compare to DSCB:15-8482(b)(2)(vi) (relating to Certificate of
Termination).
In compliance with the requirements of the applicable provisions of 15 Pa.C.S.
§ 8482(b)(2)(i)
(relating to
Certificate of Dissolution), the undersigned general partnership, desiring to wind up its business, hereby states that:
1. The name of the partnership is: ______________________________________________________
_____
2. Complete part (a) OR (b) – not both:
(a) The partnership is a domestic general partnership that has not elected limited liability status and the address,
including number and street, if any, of its principal place of business is:
___________________________________________________________________________________________________
Number and street of principal office
City
State
Zip
County
(b) The partnership is a domestic general partnership that has elected limited liability status, and the (1) address of
its current registered office in this Commonwealth or (2) name of its commercial registered office provider and the
county of venue is: (Complete (1) or (2), not both)
(1) ________________________________________________________________________________________________
Number and Street
City
State
Zip
County
(2) ________________________________________________________________________________________________
Name of Commercial Registered Office Provider
County
3. The partnership is dissolved.
IN TESTIMONY WHEREOF, the undersigned general partnership has caused this Certificate of Dissolution to be signed
by a duly authorized representative thereof this ___________ day of _________________________, 20_____ __ .
___________________________________________________
Name of General Partnership
___________________________________________________
Signature
___________________________________________________
Title