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FORM UPA-805
March 2009
Illinois Uniform Partnership Act
Statement of Dissolution
Submit in duplicate. Please type or print clearly. This space for use by Secretary of State. Date: Assigned File #: Filing Fee: $100 Approved:
File #:
This space for use by Secretary of State.
Secretary of State Department of Business Services LLP/RLLP Division Uniform Partnership Section 357 Howlett Building Springfield, IL 62756 217-785-8960 www.cyberdriveillinois.com
1. Partnership Name: 2. File Number:
(Name must be stated exactly as on record with the Secretary of State.)
Federal Employer Identification Number:
3. The above-named partnership has dissolved and is winding up its business. I/We declare, under the penalty of perjury, under the laws of the State of Illinois, that the foregoing is true, correct and complete. Executed on the
Day
of
Month
,
Year
by a partner.
Signature
Number, Street Address
Name and Title (type or print)
City, State, ZIP
Signature
Number, Street Address
Name and Title (type or print)
City, State, ZIP
Please submit this form in duplicate along with the $100 filing fee. Signatures must be in BLACK INK on an original document.
Printed by authority of the State of Illinois. May 2009- 200 - UPA 11.3