FLORIDA DEPARTMENT OF STATE
DIVISION OF CORPORATIONS
Attached is a form to convert a “Florida Profit Corporation” into an a business entity formed
under the laws of another jurisdiction pursuant to section 607.11933, Florida Statutes. This form
is basic and may not meet all conversion needs. The advice of an attorney is recommended.
Filing Fee: $35
Certified Copy (optional): $8.75
Certificate of Status (optional) $8.75
Send one check in the total amount payable to the Florida Department of State.
Please include a cover letter containing your telephone number, return address and certification
requirements, or complete the attached cover letter.
Mailing Address: Street Address:
Amendment Section Amendment Section
Division of Corporations Division of Corporations
P.O. Box 6327 The Centre of Tallahassee
Tallahassee, FL 32314 2415 N. Monroe Street, Suite 810
Tallahassee, FL 32303
For further information, you may contact the Registration Section at (850) 245-6050.
CR2E104 (1/20)
COVER LETTER
TO: Amendment Section
Division of Corporations
SUBJECT:
Name of Florida Profit Corporation
The enclosed Articles of Conversion and fee(s) are submitted to convert a Florida Profit Corporation into an a
business entity formed under the laws of another jurisdiction in accordance with s. 607.11933, F.S.
Please return all correspondence concerning this matter to:
Contact Person
Firm/Company
Address
City, State and Zip Code
E-mail address: (to be used for future annual report notification)
For further information concerning this matter, please call:
at ( )
Name of Contact Person Area Code and Daytime Telephone Number
Enclosed is a check for the following amount:
$35.00 Filing Fee $43.75 Filing Fee $43.75 Filing Fee $52.50 Filing Fee,
and Certificate of and Certified Copy Certified Copy, and
Status Certificate of Status
Mailing Address: Street Address:
Amendment Section Amendment Section
Division of Corporations Division of Corporations
P.O. Box 6327 The Centre of Tallahassee
Tallahassee, FL 32314 2415 N. Monroe Street, Suite 810
Tallahassee, FL 32303
607.1622 (10) As a condition of a conversion of a domestic corporation to another type of entity under
s. 607.11930, the domestic corporation converting to the other type of entity must be active and current in
filing its annual reports in the records of the department through December 31 of the calendar year in
which the articles of conversion are submitted to the department for filing.
Articles of Conversion
For
Florida Profit Corporation
Into a
Non-Florida Business Entity
The Articles of Conversion are submitted to convert the following Florida Profit Corporation into an a
business entity formed under the laws of another jurisdiction in accordance with s. 607.11933, Florida
Statutes.
1. The name of the Florida Profit Corporation converting into the (converted) resulting business entity is:
Enter Name of Florida Profit Corporation
2. The name of the resulting business entity is:
Enter Name of (Converted) Resulting Business Entity
3. The (converted) resulting entity is a
(Enter entity type. Example: limited liability company, limited partnership, general partnership,
common law or business trust, etc.)
organized, formed or incorporated under the laws of
.
(Enter state, or if a non-U.S. entity, the name of the country)
4. The above referenced Florida Profit Corporation has converted into another business entity in
compliance with Chapter 607, F.S.
5. The plan of conversion was approved by the converting Florida Profit Corporation in accordance with
Chapter 607, F.S.
Pursuant to s. 607.11933(4)(6) F.S. The conversion becomes effective at the later of:
1. The date and time provided by the organic law of the (converted) resulting entity; or
2. When the articles of conversion take effect.
Signed this day of 20
.
Signature:
(Must be signed by a Director, Officer, or, if Directors or Officers have not been selected, an
Incorporator.)
Printed Name: Title:
Fees: Filing Fee: $35.00
Certified Copy: $8.75 (Optional)
Certificate of Status: $8.75 (Optional)
click to sign
signature
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