Secretary of State 
                                                                                     Business Programs Division 
                                                                                                Business Entities 
                                                                           1500 11th Street, Sacramento, CA 95814 
                                                                    P.O. Box 944260, Sacramento, CA 94244-2600 

                                    Business Entities Submission Cover Sheet

                                For faste stservice, file online at      bizfileOnline.sos.ca.gov. 

Instructions: 

• Complete and include this form with your paper submission. This form will not be made part of
  the filed document.

• Make all checks or money orders payable to the Secretary of State.

• In-person submissions (excluding Statements of Information): $15                      special handling fee  D. o not
  include                       a $15 special handling fee when submitting documents by mail.

• All submissions are reviewed in the date order of receipt ,                 with online submissions given priority.
  For updated processing time information, visit www.sos.ca.gov/business/be/processing-dates.

•    obtainTo a certified copy,               includ ecertification fees with your submission.

                                Note: All correspondence related to your submission will be 
                                sent to the name and address on your check or money order.

Contact Person                        (Please type or print legibly): 

First Name:                                                      Last Name: 

Phone Number:                                                   Email:

Entity Information (Please type or print legibly): 

Entity Name:  

Entity Number (if applicable): 

Comments: 

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Submission Cover Sheet (REV 03/2024) 

                Instructions for Completing the Statement of Dissolution (Form GP-4) 

Legal Authority:     Statutory filing provisions are found in California Corporations Code section 
16805.  All statutory references are to the California Corporations Code, unless otherwise 
indicated. 

• A Statement of Partnership Authority (Form GP-1) must be filed with the Secretary of State
  of California prior to filing a Statement of Dissolution (Form GP-4).

Fees:      There is no fee for filing a Statement of Dissolution (Form GP-4).  However, a non-
refundable $15.00 handling fee is applicable for processing documents delivered in person (drop off) at the 
Sacramento office.

Copies:      Upon  filing,  we  will  return  one  (1)  plain  copy  of  your  filed  document  for  free,  and  will 
certify the copy upon request and payment of an additional $5 certification fee.  

Complete the Statement of Dissolution (Form GP-4) as follows: 

Item 1.      Enter the name of the partnership as filed with the Secretary of State of California.    

Item 2.      Enter the entity number issued to the partnership by the Secretary of State of California. 

Item 3.      Execution of this document confirms the following statement, which has been preprinted on 
             this form  and should not be altered: “THE ABOVE NAMED  PARTNERSHIP HAS 
             DISSOLVED AND IS WINDING UP ITS BUSINESS”. 

Item 4.      The partnership may include other information, as desired.   Attach additional pages, if 
             necessary, and enter the number of pages attached in Item 5. 

Item 5.  Enter the number of pages attached, if any. 

Item 6.      The Statement of Dissolution (GP-4) shall be executed as provided in Sections 16105(c) and 
             16805(a).      

Item 7.  Enter the name and mailing address of the person or firm to whom a copy of the filing is to 
             be returned. 

GP-4  (REV 03/2022)                                                       2022 California Secretary of State 
                                                                                  bizfileOnline.sos.ca.gov

                                                      State of California                                       Form GP-4 
                                                      Secretary of State 

                                      STATEMENT OF DISSOLUTION 

                           IMPORTANT – Read instructions before completing this form. 

1.  NAME OF PARTNERSHIP:                                                       2.      SECRETARY OF STATE ENTITY NUMBER:

3.  THE ABOVE NAMED PARTNERSHIP HAS DISSOLVED AND IS WINDING UP ITS BUSINESS   .       (DO NOT ALTER THIS STATEMENT      )
4.  OTHER MATTERS ,IF ANY (ATTACH ADDITIONAL PAGES IF NECESSARY):

5.  NUMBER OF PAGES ATTACHED ,IF ANY:
6.   I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT     THIS SPACE FOR FILING USE ONLY
    THE FOREGOING IS TRUE AND CORRECT.
                                                                                       DOCUMENT   #  

    SIGNATURE OF PARTNER                              DATE EXECUTED

    TYPE OR PRINT NAME OF PARTNER                     COUNTY AND STATE EXECUTED

    SIGNATURE OF PARTNER                              DATE EXECUTED

    TYPE OR PRINT NAME OF PARTNER                     COUNTY AND STATE EXECUTED

7.  RETURN TO:
    NAME:
    ADDRESS:
    CITY:                                    STATE:              ZIP CODE: 

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