FLORIDA DEPARTMENT OF STATE  
                         DIVISION OF CORPORATIONS 
                                                  
Attached is a form to convert a “Florida Limited Liability Company” into an “Other 
Business Entity” pursuant to section 605.1045, Florida Statutes.  This form is basic and 
may not meet all conversion needs.  The advice of an attorney is recommended. 
 
Pursuant to s. 605.0102(23) a, F.S., entity means: a business corporation, a nonprofit 
corporation, a general partnership, including a limited liability partnership, including a 
limited partnership, including a limited liability limited partnership; a limited liability 
company; a real estate investment trust; or any other domestic or foreign entity that is 
organized under an organic law.  
 
Filing Fee:                       $25.00 
 
Certified Copy (optional):        $30.00 
 
Certificate of Status (optional): $ 5.00 
 
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. 
 
Important Notice: As a condition of conversion, pursuant to s.605.0212(10), F.S., each party to the 
conversion must be active and current through December 31 of the calendar year this document is being 
submitted to the Department of State for filing. 
 
CR2E106 (05/17) 

                                                           COVER LETTER 
                                                                
TO: Registration Section 
    Division of Corporations 
 
SUBJECT:                                                                                   
                                 Name of Florida Limited Liability Company 
                                                                
The enclosed Articles of Conversion and fee(s) are submitted to convert a Florida 
Limited Liability Company” into an “Other Business Entity” in accordance with  
s.605.1045, F.S. 
 
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 ☐ $30.00 Filing Fee                        ☐$55.00 Filing Fee ☐ $60.00 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 
 
CR2E106 (05/17) 
 

                            Articles of Conversion 
                             For 
                           Florida Limited Liability Company  
                             Into 
                           “Converted or Other Business Entity” 
                                                                                      
The Articles of Conversion is submitted to convert the following Florida Limited 
Liability Company into an “Other Business Entity” in accordance with s. 605.1045, 
Florida Statutes. 
 
1.  The name of the Florida Limited Liability Company converting into the “Other 
Business Entity” is: 
 
                                                                                             . 
                           Enter Name of Florida Limited Liability Company 
 
2.  The name of the “Converted or Other Business Entity” is: 
 
                                                                                             . 
                           Enter Name of “Converted or Other Business Entity” 
 
3.  The “Converted or Other Business Entity” is a                                                                       
(Enter entity type.  Example:  corporation, limited partnership, sole proprietorship, general 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) 
The formation document is attached (if applicable).  
 
4.  The plan of conversion was approved by the converting Florida Limited Liability 
Company in accordance with Chapter 605, F.S. 
                                                                                      
 5. This conversion shall be effective in Florida on:                                                 . 
(The effective date:  1) cannot be prior to nor more than 90 days after the date this document is filed by the Florida 
Department of State; AND 2) must be the same as the effective date of the conversion under the laws governing the 
“Other Business Entity.”) 
 
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. 
 
                             Page 1 of 2

 6.  If the “Converted or Other Business Entity” is an out-of-state entity not registered to 
     transact business in Florida, the “Converted or Other Business Entity”: 
 
      a.) Lists the following street and mailing address of an office the Florida     
      Department of State may send and process served on the department pursuant to 
      605.0117 and Chapter 48.  
 
Street Address:                                                                                      
 
Mailing Address:                                                                                     
 
7.  The “Converted or Other Business Entity” has agreed to pay any members having   
     appraisal rights the amount to which such members are entitled under ss. 605.1006  
     and 605.1061-605.1072, F.S.  
 
Signed this                            day of                                                 , 20   
 
Signature:                                                                                           
                                      Must be signed by a Member or Authorized Representative 
                                                
Printed Name:                                  Title:                                                
 
Fees: Filing Fee:                      $25.00 
      Certified Copy:                  $30.00 (Optional) 
      Certificate of Status:           $5.00 (Optional) 
                                                 
                                               Page 2 of 2