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LP 1108
FILE #
Illinois
Form
Uniform Limited Partnership Act
This space for use by Secretary of State.
August 2012
Secretary of State
Merger
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 357
SUBMIT IN DUPLICATE
Springfield, IL 62756
Please type or print clearly.
217-524-8008
Payment may be made by check
Filing Fee: $50
payable to Secretary of State. If check
Approved:
is returned for any reason this filing
Please do not send cash.
will be void.
1. Name, Type and Jurisdiction of each Entity that is party to the merger:
________________________________
________________
____________
______________
Name of Entity
Type of Entity
Jurisdiction
File Number
________________________________
________________
____________
______________
Name of Entity
Type of Entity
Jurisdiction
File Number
________________________________
________________
____________
______________
Jurisdiction
Name of Entity
Type of Entity
File Number
________________________________
________________
____________
______________
Name of Entity
Type of Entity
Jurisdiction
File Number
2. The merger has been approved by each entity that is a party to the merger in accordance with Sections
1106-1109.
3. Name of Surviving Entity:_________________________________________________________________
Name
________________________________________________________________________________________
Type of Entity
Jurisdiction
________________________________________________________________________________________
Jurisdiction
Mailing Address
City/State
ZIP
4. Effective Date of Merger (check one):
filing date
a later date, but not more than 30 days subsequent to the filing date ____________________________
Date (month, day, year)
5. If the surviving entity is created by this merger, the organizational document must be attached.
6. If there are changes to the surviving entity by reason of this merger, the changes must be set forth below:
For additional space, continue in the same format on a plain white 8.5 x 11 sheet of paper.
_____________________________________________________________________________________
_____________________________________________________________________________________
♻ Printed on recycled paper. Printed by authority of the State of Illinois. March 2013 — 1 — C LP 23.7