COVER LETTER 
                                                 
TO: Registration Section 
    Division of Corporations 
 
SUBJECT:                                                                                             
                              Name of Limited Liability Company 
                                                 
Dear Sir or Madam: 
 
The enclosed Statement of Abandonment of Merger 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 
 
            E-mail address: (to be used for future annual report notification) 
 
For further information concerning this matter, please call: 
 
                                                 at (         )                                      
        Name of Person                                  Area Code          Daytime Telephone Number 
 
    Mailing Address:                                          Street Address: 
    Amendment Section                                         Amendment 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 
                
CR2E137 (2/14) 

                      STATEMENT OF ABANDONMENT OF MERGER 

Pursuant to section 605.1024(4), Florida Statutes, I hereby submit the following Statement of Abandonment of 
Merger prior to the effective date of the merger: 
 
FIRST:  The names of each party to the plan of merger: 
 
SECOND:  The date articles of merger the articles of merger were delivered for filing  
 
              is:                                                                        
        
THIRD:   The merger has been abandoned in accordance with 605.1024(4). 
 
                 Authorized Representative                     Typed or Printed Name of Signature 
 
       Signature of Authorized Representative                  Typed or Printed Name of Signature 
                                                        
                       Filing Fee:                      $25.00 
                       Certified Copy:  $30.00 (optional) 
 
CR2E137 (2/14)