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Domesticllcstatementofdissociation20180215 RETURN TO

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Domesticllcstatementofdissociation Feb 2018
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
The undersig
ned hereby files this statement of dissociation pursuant to SDCL 47-34A-605.
1. The Name and Business ID of the company is:
Name (Note: This must be the exact limited liability company name as registered.) Business ID
2. The name of the member dissociated from the company: ________________________________________________
3. A copy of this statement has been delivered to the limited liability company:
Yes No
The cancellation must be signed by a member if the LLC is member-managed or by a manager if the LLC is manager-
managed or in accordance with SDCL 47-34A-205.
No person may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal
penalty (SDCL 22-39-36).
Dated
Signature of an authorized person
Email
(Optional) Printed Name
Title
STATEMENT OF DISSOCIATION
DOMESTIC LIMITED LIABILITY COMPANY
SDCL 47-34A-605
FILING FEE: $10
Make check payable to SECRETARY OF STATE
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Completed 3 July 2020

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