Dissolution Of Certificate Of Organization (LLC)

This form must be type written or computer generated. State of Utah Department of Commerce Division of Corporations & Commercial Code Dissolution of Certificate of Organization _________________________________________________________________ Limited Liability Company Name Pursuant to the provisions of the Utah Limited Liability Company Act, the undersigned Limited Liability Company adopts the following Dissolution: Entity Number: ____________________ First: The address to which service of process may be mailed pursuant to Title 16, Chapter 17, Model Registered Agents Act: ____________________________________________________________________________________________ (Utah Street Address Required, PO Boxes can be listed after the street address) _____________________________________________________________________________________________ City State Zip Second: Third: The effective date of the dissolution ____________________________. Reason for dissolution: ______________________________________________________________________________ ______________________________________________________________________________ ~OR~ Dissolution occurred by written agreement of the members. Affirm Here: Under penalties of perjury, I declare that this Dissolution has been examined by me and are, to the best of my knowledge and belief, true, correct and complete. By: ________________________________________ Title: ______________________ Date: _____________ Must be signed by a person authorized by the limited liability company Additional filing requirements: If the filer requests a copy of the Dissolution an additional exact copy of the filed document along with a returnaddressed envelope with adequate first-class postage must also be submitted. Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity. 01/14 American LegalNet, Inc. www.FormsWorkFlow.com