COVER LETTER
TO: Registration Section
Division of Corporations
SUBJECT:
Name of Limited Liability Company
Dear Sir or Madam:
The enclosed Withdrawal Statement and fee(s) are submitted for filing.
Please return all correspondence concerning this matter to the following:
Name of 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 Person Area Code Daytime Telephone Number
Mailing Address: Street Address:
Registration Section Registration 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
CR2E140 (2/14)
WITHDRAWAL STATEMENT
Pursuant to section 605.0208, Florida Statutes, I hereby submit the following withdrawal statement withdrawing a
record before it takes effect:
FIRST: The name of the limited liability company is:
SECOND: The Florida Document number of the limited liability company is:
THIRD: The record to be withdrawn is:
FOURTH: Please check the appropriate box
This withdrawal statement is signed by all the persons who signed the record being withdrawn.
or
This record is withdrawn in accordance with the agreement of all the persons who signed the record.
Signature of person submitting withdrawal Typed or printed name of signature
Signature of person submitting withdrawal Typed or printed name of signature
Signature of person submitting withdrawal Typed or printed name of signature
Signature of person submitting withdrawal Typed or printed name of signature
Filing fee: $25.00
Certified Copy: $30.00 (optional)
CR2E140 (2/14)