State of
Delaware
Certificate of
Cancellation
Of
__________________________________
FIRST: The name of the limited liability company is
_____________.
SECOND: The Certificate of Formation of the limited liability company was
filed on _________.
THIRD: The reason for filing of the Certificate of
Cancellation is the company is winding up its affairs and terminating its
business.
In Witness Whereof, the undersigned has executed this Certificate of Cancellation of
___________________________, this ___ day of _____________, AD 20___.
SIGNED:___________________
NAME: ____________________
Authorized Person