Application For Withdrawal Domestic {LLC-5.40}

1.Limited Liability Company Name:2.The company has submitted prospective Articles of Organization filed on Datewith a pending effective date of . In accordance with Section 5-40(b) of the IllinoisLimited Liability Company Act, the Organizer hereby withdraws the Articles of Organization to prevent the filing frombecomingeffective.3.The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this application for withdrawal is tothe best of my knowledge and belief, true, correct and complete.Dated: , Month/Day YearSignature of OrganizerName (type or print)If organizer is a Company or other Entity, state Name of Company and Title of Signer.FormLLC-5.40May 2012Illinois Limited Liability Company ActApplication for Withdrawal 205Domestic Printed by authority of the State of Illinois. December 2017 204 1 204 LLC 12.6 SUBMIT IN DUPLICATEType or Print Clearly.This space for use by Secretary of State.Filing Fee: $5Approved:Secretary of State Department of Business ServicesLimited Liability Division501 S. Second St., Rm. 351Springfield, IL 62756217-524-8008www.cyberdriveillinois.com Payment may be made by checkpayable to Secretary of State. Ifcheck is returned for any reason thisfiling will be void. This space for use by Secretary of State.FILE # American LegalNet, Inc. www.FormsWorkFlow.com