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

                                                   Submission Cover Sheet

For faster service, file online at bizfileOnline.sos.ca.gov               . 

Instructions: 

• Complete and include this form with your paper submission. This information only will be
  used to communicate in writing about the submission, if needed. This form will be
  treated as correspondence and 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 handling fee; do not include
  a $15 handling fee when submitting documents by mail.

• Standard processing time for submissions to this office is approximately 5 business days from
  receipt. 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.

Optional Copy and Certification Fees: 

• If applicable, include optional certification fees with your submission.

• For applicable certification fee information, refer to the instructions of the specific form you are
  submitting.

Contact Person: (Please type or print legibly) 

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Entity Information: (Please type or print legibly) 

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Comments

Submission Cover Sheet (REV 03/2022)                            Clear Form  Print Form

              Secretary of State                                    LLC-4/8

              Short Form Cancellation Certificate 
              Limited Liability Company (LLC) 
              ONLY California LLC Formed in California in 
              the Last 12 Months 

There is No Fee for filing a Short Form Cancellation Certificate 

Certification Fee (Optional)  –$5.00 

                                                                               This Space For Office Use Only 
1. Limited Liability Company Name (Enter the exact name of the LLC as it is recorded with the California Secretary of State)

2. LLC 12-Digit Entity (File) Number (Enter the exact 12-digit Entity (File) Number issued by the California Secretary of State.)

3. Required Statements (Do not alter the Required Statements – ALL must be true to file Form LLC-4/8)
Statements 3(a) – 3(g) are true: 
   (a) This Short Form Certificate of Cancellation is being filed within twelve (12) months from the date the Articles of
    Organization were filed with the California Secretary of State;
   (b) The LLC does not have any debts or other liabilities, except as provided in Item 3(c);
   (c) All final tax returns required under the California Revenue and Taxation Code have been or will be filed with the
    California Franchise Tax Board;
   (d) The known assets of the LLC remaining after payment of, or adequately providing for, known debts and
    liabilities have been distributed or the LLC has acquired no known assets;
   (e) The LLC has not conducted any business from the time of the filing of the Articles of Organization;
   (f) 50 percent or more of the voting interests of the managers or members voted, or, if no managers or members,
    the person or 50 percent or more of the persons signing the Articles of Organization, voted to dissolve the LLC;
    and
   (g) Payments received by the LLC for interests from investors, if any, have been returned to those investors.
Note:  If the LLC cannot say all of these items are true, the LLC cannot file this Short Form Cancellation Certificate 
(Form LLC-4/8) and must follow the normal cancellation process.  See Certificate of Cancellation (  Form LLC-4/7  ), and 
if applicable, Certificate of Dissolution (Form LLC-3). 
4. Cancellation Statement (Do not alter Cancellation Statement)
Upon the effective date of this Short Form Cancellation Certificate, the Limited Liability Company’s registration is 
cancelled and its powers, rights and privileges will cease in California. 
5. Read and Sign Below             (Do not use a computer generated signature.)
By signing, I affirm under penalty of perjury that the information herein is true and correct and that I am authorized by 
California law to sign. 

 ________________________________________________________________               _______________________________________________ 
   Signature                                                                   Type or Print Name 

 ________________________________________________________________               _______________________________________________ 
    Signature                                                                    Type or Print Name 
LLC-4/8 Instructions (REV 03/2022)               Clear Form Print Form                               2022 California Secretary of State 
                                                                                                     bizfileOnline.sos.ca.gov