Foreign Cancellation (Limited Liability Companies)

Delaware Division of Corporations 401 Federal Street Suite 4 Dover, DE 19901 Ph: 302-739-3073 Fax: 302-739-3812 C ertificate of Cancellation of a Foreign Limited Liability Company Dear Sir or Madam: Enclosed is the Certificate of Cancellation of a Foreign Limited Liability Company to be filed in accordance with the Limited Liability Company Act of the State of Delaware. The fee to file the Certificate is $100.00 and you will receive a stamped Filed copy of your submitted document. A certified copy may be requested for an additional $30. Expedited services are available. Please contact our office concerning these fees. Please contact our Franchise Tax Section concerning any taxes due at the time of cancellation. A check for the tax payment and filing fee must accompany the Certificate for filing. Please make your check payable to the Delaware Secretary of State. For the convenience of processing your order in a timely manner, please include a cover letter with your name, address and telephone/fax number to enable us to contact you if necessary. Please make sure you thoroughly complete all information requested on this form. It is imbe legible, we request portant that the execution that you print or type your name under the signature line. Thank you for choosing Delaware as your corporate home. Should you require further assistance in this or any other matter, please dont hesitate to call us at (302) 739-3073. S incerely, D epartment of State Division of Corporations encl. rev. 6/04 <<<<<<<<<********>>>>>>>>>>>>> 2 STATE OF DELAWARE CERTIFICATE OF CANCELLATION OF REGISTRATION of a foreign limited liability company (*Insert the name the comany is using ip n Delaware) 1. The name under which the foreign limited liability company is registered and is doing business in the State of Delaware is *_______________________________ _______________________________________________________________.** (**If the companys true name in its home jurisdiction is different, add the following: "The name under which the foreign limited liability company was formed is _________________________________________________________ ________________________________________________________________.") 2. The Certificate of Registration of the foreign limited liability company was duly endorsed as filed by the Secretary of State of Delaware on __________________ _________________________________________________________________. 3. The effective date of cancellation, if different than the date of filing of this Certificate with the Secretary of State, is ________________________________ _________________________________________________________________. 4. The authority of the Secretary of State to accept service of process for the foreign limited liability company with respect to causes of action arising out of the transaction of business in the State of Delaware survives the filing of this Certificate and remains in effect. 5. The address in the jurisdiction of organization of the foreign limited liability company to which the Secretary of State can forward service of process is __________________________________________________________________ _________________________________________________________________. IN WITNES, the undersigned has executed this Certificate of S WHEREOFCancellation this ________________ day of ________________, A.D. ______. By:________________________________ A uthorized Person(s) Name:_____________________________ P rint or Type