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Form Dpc - Articles Of Entity Conversion Of A Foreign Other Entity To A Domestic Business Corporation Page 4

COMMONWEALTH OF MASSACHUSETTS

William Francis Galvin

Secretary of the Commonwealth

One Ashburton Place, Boston, Massachusetts 02108-1512

Articles of Entity Conversion of a

Foreign Other Entity to a

Domestic Business Corporation

(General Laws, Chapter 156D, Section 9.53;

950 CMR 113.31)

I hereby certify that upon examination of these articles of conversion, duly submitted

to me, it appears that the provisions of the General Laws relative thereto have been

complied with, and I hereby approve said articles; and the ﬁ ling fee in the amount of

$______ having been paid, said articles are deemed to have been ﬁ led with me this

_____________ day of _____________

day of _____________

day of

, 20______ , at _______a.m./p.m.

time

Eﬀ ective date: _________________________________________________

(must be within 90 days of date submitted)

WILLIAM FRANCIS GALVIN

Secretary of the Commonwealth

Examiner

Filing fee: Minimum $250

Name approval

TO BE FILLED IN BY CORPORATION

Contact Information:

___________________________________________________________

Telephone: ___________________________________________________

Email: ______________________________________________________

Upon ﬁ ling, a copy of this ﬁ ling will be available at

If the document is rejected, a copy of the rejection sheet and rejected document will

be available in the rejected queue.

Form Dpc - Articles Of Entity Conversion Of A Foreign Other Entity To A Domestic Business Corporation Page 4