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Certificate Of Conversion For Entities Converting Into The Records 800 - Ohio
| Certificate Of Conversion For Entities Converting Into The Records Form. This is a Ohio form and can be used in Mergers And Consolidations Secretary Of State . |
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Form 800 Prescribed by the: Ohio Secretary of State Central Ohio: (614) 466-3910 Toll Free: (877) SOS-FILE (767-3453) www.OhioSecretaryofState.gov Busserv@OhioSecretaryofState.gov Mail this form to one of the following: Regular Filing (non expedite) P.O. Box 788 Columbus, OH 43216 Expedite Filing (Two-business day processing time requires an additional $100.00). P.O. Box 1390 Columbus, OH 43216 Certificate of Conversion for Entities Converting Into the Records of the Ohio Secretary of State Filing Fee: $125.00 Name of Converting Entity Jurisdiction of Formation The converting entity: (Check Only (1) One Box) Partnership Foreign Limited Partnership Common Law Trust Foreign Corporation Foreign Non Profit Limited Liability Company Foreign For-Profit Limited Liability Company Foreign Limited Liability Partnership Other The converting entity hereby states it has complied with all laws of its jurisdiction of formation. Furthermore, the law permits for the conversion. Name of the Converted Entity Existing under the laws of Ohio The converted business entity type is (Check One) Business Trust Domestic Corporation Domestic Nonprofit Limited Liability Company Domestic For-Profit Limited Liability Company Partnership Domestic Limited Partnership Domestic Limited Liability Partnership Form 800 Page 1 of 2 Last Revised: 2/6/12 American LegalNet, Inc. www.FormsWorkFlow.com Effective Date (Optional) This conversion is effective on (If a date is specified, the date must be a date on or after the date of the filing. If no date is specified, the date of filing will be the effective date of the conversion). The name and address of the person or entity that will provide a copy of the declaration of conversion upon written request Print Name Mailing Address City State Zip Code If the conversion creates a new domestic corporation, limited liability company, partnership, limited partnership, or a limited liability partnership, complete and attach the formation documents prescribed by the secretary of state for the specific entity type being created. The authorized representative(s) identified below certify that the declaration of conversion is authorized on behalf of the converting entity and that each person signing the certificate of conversion is authorized to do so. Required Must be signed by an authorized representative. Signature By (if applicable) Print Name Signature By (if applicable) Print Name Form 800 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 2/6/12 Instructions for Certificate of Conversion for Entities Converting INTO the Records of the Secretary of State This form should be used to file a certificate of conversion to document that an entity converted into the records of the Ohio Secretary of State. Converting Entity Information Pursuant to Ohio Revised Code §§1701.811, §1705.381, §1776.72 and §1782.4310, the certificate of conversion must set forth the name of the converting entity, its jurisdiction of formation and the form of the converting entity (for example, corporation, limited liability company, etc). Also the authorized representative signing the certificate is agreeing to the statement that the converting entity has complied with all of the laws under which it exists and that the laws permit the conversion. Converted Entity Information You must state the name of the converted (resulting) entity, the jurisdiction under the laws of which the converted entity exists, and the form of the converted entity. Effective Date An effective date may be provided but is not required. The conversion is effective upon filing of the certificate of conversion or on a later date specified in the certificate. Please note, if the date provided precedes the date of filing, the effective date will be the date of filing. Name and Mailing Address Provide the name and mailing address of a person or entity that is to provide a copy of the declaration of conversion in response to any written request made by a shareholder, partner, or member of the converting entity. Additional Requirements Pursuant to Ohio Revised Code §§1701.811, §1705.381, §1776.72 and §1782.4310, in the case of a conversion into a new domestic corporation, limited liability company, limited partnership, or other partnership, any formation documents that would be filed upon the creation of the converted entity shall be filed with the certificate of conversion. For example, if a new corporation is created through the conversion, Articles of Incorporation must be filed with the Certificate of Conversion. There is no additional fee to file the formation documents. Additional Provisions If the information you wish to provide for the record does not fit on the form, please attach additional provisions on a single-sided, 8 1/2 x 11 sheet(s) of paper. Signature(s) After completing all information on the filing form, please make sure that the form is signed by at least one authorized representative on behalf of the converting entity. The authorized representative is signing a statement that the declaration of conversion is authorized on behalf of the converting entity and that each person signing the certificate on behalf of the converting entity is authorized to do so. Please include the title of each authorized representative beneath the signature line. ** Note: Our office cannot file or record a document that contains a social security number or tax identification number. Please do not enter a social security number or tax identification number, in any format, on this form. Form 800 Last Revised: 2/6/12 American LegalNet, Inc. www.FormsWorkFlow.com
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