New York State 
                                                                                                   Department of State 
                                                                                                  DIVISION OF CORPORATIONS, 
                                                                                                   STATE RECORDS AND  
                                                                                                  UNIFORM COMMERCIAL CODE 
                                                                                                   One Commerce Plaza 
                                                                                                        99 Washington Ave. 
                                                                                                   Albany, NY 12231-0001 
                                                                                                        www.dos.ny.gov 
 
                         CERTIFICATE OF WITHDRAWAL 

                                OF 
 
                               (Insert Name of Domestic Registered Limited Liability Partnership) 
                                Under Section 121-1500(f) of the Partnership Law 
 
 FIRST:           The name of the registered limited liability partnership is: 
                                                                                                        . 
 If the name of the registered limited liability partnership has been changed, the name under which 
 it was registered is: 

                                                                                                        . 
 
 SECOND: The date the certificate of registration was filed with the Department of State is: 

                                                                                                        . 
 
 THIRD: The address of the registered limited liability partnership’s principal office is: 
 
                                                                                                        . 
 
 FOURTH:                 The registered limited liability partnership acknowledges that this withdrawal 
 terminates its status as a registered limited liability partnership. 
 
                X                   
 (Signature of Partner) 
 
 (Print or Type Name of Signer) 

 DOS-1530-f (Rev. 04/17)                                                                                    Page 1 of 2

                          CERTIFICATE OF WITHDRAWAL 

                                                         OF 
 
                            (Insert Name of Domestic Registered Limited Liability Partnership) 
                             Under Section 121-1500(f) of the Partnership Law 
 
 Filer’s Name and Mailing Address: 

  Name: 

  Company, if Applicable: 

  Mailing Address:

  City, State and Zip Code: 
                              
  NOTES:  
  1. The name of the registered limited liability partnership and the date the certificate of registration was filed by  
      the Department of State provided on this certificate must exactly match the records of the Department of 
      State.  This information should be verified on the Department of State’s website at www.dos.ny.gov. 
  2. This form has been prepared by the New York State Department of State for filing a certificate of withdrawal 
      for a domestic registered limited liability partnership. This form does not contain all optional provisions under  
      the law. You are not required to use this form. You may draft your own form or use forms available at legal  
      stationery stores.  
  3. The Department of State recommends that legal documents be prepared under the guidance of an attorney.  
  4. This certificate must be accompanied by a fee of $60 made payable to the Department of State. 
  
  (For DOS Use Only) 

 DOS-1530-f (Rev. 04/17)                                                                                                     Page 2 of 2