UPA-83D-CANC (10/01) COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION CANCELLATION OF PARTNERSHIP STATEMENT The undersigned present this cancellation for filing pursuant to 50-73.83D of the Code of Virginia.(Note: A cancellation of a partnership statement cannot be filed with the State Corporation Commissionunless the partnership statement being canceled was previously filed and is of record with the Commission.)1. The name of the partnership is: ________________________________________________________________________________ 2. The partnership was filed with the State Corporation Commission on ________________________, (month, day, year) file number _______________________. 3. This cancellation cancels the following statement which was filed on ________________________. (month, day, year) (MARK ONE) Statement of Partnership Authority Statement of Denial Statement of Dissociation Statement of Dissolution Statement of Merger 4. Text/Substance of Cancellation: The individuals executing this doc ument personally declare under pe nalty of perjury that thecontents are accurate. Signed this ___________ day of __________________, 20______. Signatures of at least two partners: ___________________________________________________________________________ INSTRUCTIONS ON THE REVERSE <<<<<<<<<********>>>>>>>>>>>>> 2 INSTRUCTIONS Section 50-73.83 of the Code of Virginia requires that this cancellation be either typewritten or printed inblack, legible and reproducible. The person who files this cancellation shall promptly send a copy of the cancellation to every nonfiling partnerand to any other person named as a partner in the cancellation. Any person authorized by the Virginia Uniform Partnership Act, Chapter 2.2 of the Code of Virginia to file astatement set forth on the front of this form may cancel the statement by filing this cancellation. Submit the original, signed cancellation to the Clerk of the State Corporation Commission, PO Box 1197, stRichmond, Virginia 23218-1197 (mailing address: 1300 East Main Street, Tyler Building, 1 Floor, Richmond,Virginia 23219), along with a check for the filing fee in the amount of $25.00, payable to the State CorporationCommission. PLEASE DO NOT SEND CASH . If you have any questions, please call (804) 371-9733 or toll-free in Virginia, 1-866-722-2551. If you have Internet access, you can download this form. Go to www.state.va.us/ scc; click on Divisions; thenpoint to Corporations and click on Office of the Clerk; then Forms and Fees; then Partnership Forms andFees; and then Form UPA-83D-CANC.