FLORIDA DEPARTMENT OF STATE  
                         DIVISION OF CORPORATIONS 
                                          
Attached is a form to convert a “Florida Partnership” into an “Other Organization” 
pursuant to section 620.8914, Florida Statutes.  This form is basic and may not meet all 
conversion needs.  The advice of an attorney is recommended. 
 
Filing Fee:                       $25.00 
 
Certified Copy (optional):        $52.50 
 
Certificate of Status (optional): $8.75 
 
Send one check in the total amount payable to the Florida Department of State. 
 
Please include a cover letter containing your telephone number, return address and 
certification requirements, or complete the attached cover letter. 
 
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 
 
For further information, you may contact the Registration Section at (850) 245-6051. 
 
CR2E116 (06/09) 

                                                           COVER LETTER 
                                                                
TO: Registration Section 
    Division of Corporations 
 
SUBJECT:                                                                                                            
                             Name of Florida Partnership 
                                                                
The enclosed Certificate of Conversion 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 
 
         E-mail address: (to be used for future annual report notification) 
 
For further information concerning this matter, please call: 
 
                                                               at (         )                                       
               Name of Contact Person                                       Area Code and Daytime Telephone Number 
 
Enclosed is a check for the following amount: 
 
☐ $25.00 Filing Fee ☐  $33.75 Filing Fee                       ☐$77.50 Filing Fee ☐ $86.25 Filing Fee, 
                    and Certificate of                         and Certified Copy Certified Copy, and 
                    Status                                                        Certificate of Status 
 
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 
 

                 Certificate of Conversion 
                                         For 
                                  Florida Partnership  
                                         Into 
                             “Other Organization” 
                                          
This Certificate of Conversion is submitted to convert the following Florida Partnership 
into an “Other Organization” in accordance with s. 620.8914, Florida Statutes. 
 
1.  The name of the Florida Partnership converting into the “Other Organization” is: 
 
                Enter Name of Florida Partnership 
 
2.  The name of the “Other Organization” is: 
 
                 Enter Name of  “Other Organization” 
 
3.  The “Other Organization” is a                                                                
 
(Enter entity type.  Example:  corporation, limited liability company, limited partnership, 
                common law or business trust, etc.) 
                                          
organized, formed or incorporated under the laws of                                               
  (Enter state, or if a non-U.S. entity, the name of the country) 
                                          
4.  The above referenced Florida Partnership has converted into an “Other Organization” 
in compliance with Chapter 620, F.S., and the conversion complies with the applicable 
laws governing the “Other Organization.” 
 
5.  The plan of conversion was approved by the converting Florida Partnership in 
accordance with Chapter 620, F.S., and as required by the governing law of the “Other 
Organization.” 
 
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6.  This conversion was effective under the laws governing the “Other Organization”  
 
on:                                                                                   . 
 
7.  If the “Other Organization” is an out-of-state organization not registered to transact 
business in Florida, the “Other Organization” lists the following street and mailing 
address of an office the Florida Department of State may use for purposes of 
s.620.8915(3), F.S.: 
 
Street Address:                                                                             
 
Mailing Address:                                                                            
 
Signed this                    day of                  , 20                                            
 
Signature of a General Partner or Authorized Person: 
 
Fees: Filing Fee:              $25.00 
      Certified Copy:          $52.50 (Optional) 
      Certificate of Status:   $8.75 (Optional) 
       
                                Page 2 of 2