1. The articles of conversion shall state:
Entity Number: _____________________________________
First: The name and entity type of the company immediately prior to the filing of the articles of
conversion:
Name: _______________________________________________________________________________
Entity Type (Corp, LLC, LP, Partnership, DBA, etc.): ________________________________
Second: The date and state where the company was first created and, if it has changed, its jurisdiction
immediately prior to its conversion;
_______________________________ _______________________________
Date of formation State / Jurisdiction
Third: The name and entity type of the company as set forth in its converted entity filing;
Name: _______________________________________________________________________________
Entity Type: ________________________________
Fourth: The future effective date of the conversion to the new entity if it is not to be effective upon the
filing of the articles of conversion;
______________________00''<<<<
Fifth: Under penalties of perjury, I declare that the articles of conversion have been duly approved by the
owners of the entity.
Dated: ______________________________
By:_________________________________
Title: ___________________________
2. Additional filing requirements: The non-refundable processing fee of $37.00 payable to the State of Utah,
and application for new entity must accompany this form. No additional fee for the new application.
Under GRAMA {63G-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you
may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Articles of Conversion
This form cannot be hand written.
Authorized Party must sign here after the form is printed
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
