Affidavit To Dissolve Limited Liability Company (Domestic LLC) {368}

TERMINATION OF REGISTRATION(R.S. 9:3427) Return to: Foreign Partnership Enclose $150 filing fee Make remittance payable to Secretary of State Do Not Send Cash Commercial Division P. O. Box 94125 Baton Rouge, LA 70804-9125 (225) 925-4704www.sos.la.gov The Secretary of State office is hereby notified that it is the intention of the following named Foreign Partnership to terminate its registration in the State of Louisiana. Name of Foreign Partnership: Organized under the laws of: State, Country, Territory, Province or Commonwealth Municipal address of principal place of business outside Louisiana: Municipal address of principal place of business in Louisiana: The undersigned certifies that he/she is a partner of the above named partnership and that he/she has the authority to terminate said partnership registration. Partner Date SS394 Rev. 0 (see instructions on back) INSTRUCTIONS 1.A duly registered foreign partnership may terminate its registration by written notification to the secretary of state by a person who certifies that he is a partner of the partnership and has the authority to terminate the registration. www.FormsWorkflow.com