Fillable TO: Registration Section Division of Corporations The enclosed (Florida Division of Corporations)

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TO: Registration Section Division of Corporations The enclosed (Florida Division of Corporations)

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COVER LETTER
TO: Registration Section
Division of Corporations
SUBJECT:
(Name of Limited Liability Company)
The enclosed member, resignation or dissociation and fee(s) are submitted for filing.
Please return all correspondence concerning this matter to:
(Contact Person)
(Firm/Company)
(Address)
(City/State and Zip Code)
For further information concerning this matter, please call:
at ( )
(Name of Contact Person) (Area Code & Daytime Telephone Number)
Enclosed please find a check made payable to the Florida Department of State for:
☐ $25 Filing Fee ☐ $55 Filing Fee & Certified Copy
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
CR2E079 (2/14)
FLORIDA DEPARTMENT OF STATE
DIVISION OF CORPORATIONS
DISSOCIATION OR RESIGNATION OF MEMBER, MANAGER FROM
FLORIDA OR FOREIGN LIMITED LIABILITY COMPANY
(Pursuant to 605.0216, Florida Statutes)
1. The name of the limited liability company as it appears on the records of the Florida Department
of State is: .
2. The Florida document/registration number assigned to this limited liability company is:
.
3. The date this member/manager withdrew/resigned or will withdraw/resign is:
4. I, , hereby withdraw/resign as a
(Print Name of Person Resigning)
.
(Print Title)
of this limited liability company and affirm the limited liability company has been notified of my
resignation in writing.
Signature of Dissociating Member or Resigning Manager
Filing Fee: $25.00 (Required)
Certified Copy: $30.00 (Optional)
CR2E079 (2/14)
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TO: Registration Section Division of Corporations The enclosed (Florida Division of Corporations)

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Completed 29 July 2020

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