(For Office Use Only) 

                                                COVER LETTER 

TO: Reinstatement Section 
    Division of Corporations 

SUBJECT:  
                                       (Name of Partnership) 

DOCUMENT NUMBER:  

The enclosed Cancellation of Partnership Statement and fee(s) are submitted for filing. 

Please return all correspondence concerning this matter to the following: 

                      (Name of Person) 

                      (Firm/Company) 

                      (Address) 

                      (City/State and Zip Code) 

For further information concerning this matter, please call: 

                                                 at (        ) 
               (Name of Person)                                   (Area Code & Daytime Telephone Number) 

    Mailing Address:                                         Street Address: 
    Reinstatement Section                                    Reinstatement 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 

CR2E069 (9/15) 

                          CANCELLATION OF PARTNERSHIP STATEMENT 
 
Pursuant to section 620.8105(7), Florida Statutes, this partnership submits the following to cancel a partnership statement:  
 
(Note:  A cancellation of a partnership statement cannot be filed with the Florida Department of State unless the partnership statement 
being canceled was previously filed and is of record with this office.) 
 
FIRST:  The name of the partnership is:                                                                             
                                                                                                                    
SECOND: The partnership was registered with the Florida Department of State on                          
        and assigned registration number                                                               . 
 
THIRD:  This cancellation cancels the following statement  
 
        ☐  Statement of Partnership Authority filed on                  , assigned document number GP                            . 
        ☐Statement of Dissolution filed on                        , assigned document number GP                    . 
        ☐  Statement of Denial filed on                           , assigned document number GP                    . 
        ☐ Statement of Dissociation filed on                      , assigned document number GP                    . 
        ☐ Statement of Merger filed on                            , assigned document number GP                    . 
        ☐ Statement of Limited Liability Partnership Qualification filed on                            , assigned  
                                                                        document number LLP                        . 
FOURTH:  Text/Substance of Cancellation: 
 
FIFTH:        Effective date, if other than the date of filing:                                          . 
(Effective date cannot be prior to the date of filing nor more than 90 days after the date of filing.) 
NOTE:  If the date inserted in this block does not meet the applicable statutory filing requirements, this date will not be listed as the 
document’s effective date on the Department of State’s records.  
 
The execution of this statement constitutes an affirmation under the penalties of perjury that the facts stated herein are true. 
 
I am aware that any false information submitted in a document to the Department of State constitutes a third degree felony as provided 
for in s. 817.155, F.S. 
 
Signed this _____ day of ____________________________,  ______. 
 
Signatures of a partner or authorized person:                                                             
                          
Typed or printed name of person signing above:                                                            
                                         
                                          Filing Fee:                    $25.00 
                                        Certified copy:                 $52.50 (optional) 
                                        Certificate of Status:          $  8.75 (optional)