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Articles Of Entity Conversion -- Conversion Of An Indiana Non-Corporation Business Entity Into An Indiana LLC 51577 - Indiana

Articles Of Entity Conversion -- Conversion Of An Indiana Non-Corporation Business Entity Into An Indiana LLC Form. This is a Indiana form and can be used in General Corporations Secretary Of State .
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Reset Form ARTICLES OF ENTITY CONVERSION Conversion of an Indiana Non-Corporation Business Entity into an Indiana Limited Liability Company State Form 51577 (R3 / 8-14) Approved by State Board of Accounts, 2014 CONNIE LAWSON SECRETARY OF STATE CORPORATE DIVISION 302 W. Washington Street, Rm. E018 Indianapolis, IN 46204 Telephone: (317) 232-6576 INSTRUCTIONS: 1. Use 8 ½" x 11" white paper for attachments. 2. Present original and one (1) copy to the address in upper right corner of this form. 3. Please TYPE or PRINT. 4. Please visit our office on the web at Indiana Code 23-1-18-3 FILING FEE: $30.00 ARTICLES OF CONVERSION OF ____________________________________________________________________________ (hereinafter "Non-surviving Business Entity") INTO ____________________________________________________________________________ (hereinafter "Surviving LLC") ARTICLE I: PLAN OF ENTITY CONVERSION a. Please set forth the Plan of Conversion, containing such information as required by Indiana Code 23-1-38.5-11, attach herewith, and designate it as "Exhibit A." The plan must specify the following: A statement indicating that the type of business entity the surviving entity will be is an LLC; The terms and conditions of the conversion; The manner and basis of converting the interests, securities, obligations, rights to acquire interests or other securities of Non-surviving Business Entity following its conversion into the shares of Surviving LLC; and The full text, as in effect immediately after the consummation of the conversion, of the organic documents, if any, of Surviving LLC. Please read and sign the following statement. I hereby affirm under penalty of perjury that the plan of conversion is in accordance with the organic document of Non-surviving Business Entity and is duly authorized as required by the laws of the State of Indiana. Printed Name Title b. Signature ARTICLE II: NAME AND TYPE OF NON-SURVIVING BUSINESS ENTITY a. The name of Non-surviving Business Entity immediately before filing these Articles of Entity Conversion is the following: b. Please state the type of business entity of Non-surviving Business Entity below. ARTICLE III: NAME AND PRINCIPAL OFFICE OF SURVIVING LLC a. The name of Surviving LLC is the following (Please note pursuant to Indiana Code 23-18-2-8, this name must include the words "Limited Liability Company", "L.L.C.", or "LLC".) b. The address of Surviving LLC's Principal Office is the following: City State ZIP code Street Address (number and street) ARTICLE IV: REGISTERED OFFICE AND AGENT OF SURVIVING LLC Registered Agent: The name and street address of Surviving Corporation's Registered Agent and Registered Office for service of process are the following: Name of Registered Agent Address of Registered Office (number and street or building) City State ZIP code Indiana Page 1 of 2 American LegalNet, Inc. ARTICLE V: DISSOLUTION OF SURVIVING LLC Please indicate when dissolution will take place in Surviving LLC: The latest date upon which Surviving LLC is to dissolve is ______________________________________________________, Surviving LLC is perpetual until dissolution. OR ARTICLE VI: MANAGEMENT OF SURVIVING LLC Surviving LLC will be managed by: (please indicate which) The members of Surviving LLC, A manager or managers OR In Witness Whereof, the undersigned being an officer or other duly authorized representative of above-stated Surviving LLC executes these Articles of Entity Conversion and verifies, subject to penalties of perjury, that the statements contained herein are true, this ____________________________ day of _________________________________, 20____________ Required: By checking the box, the Signator(s) represent(s) that the registered agent named in the application has consented to the appointment of registered agent. Signature Printed name Title Page 2 of 2 American LegalNet, Inc.
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