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) 

First Name:                                      Last Name: 

Phone (optional):  

Entity Information: (Please type or print legibly) 

Name:  

Entity Number (if applicable):  

Address: 

Comments

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

                    Secretary of State                    LLC-3

                    Certificate of Dissolution 
                    Limited Liability Company (LLC) 
                    (California LLC ONLY) 

There is N  o Fee for filing a Certificate of Dissolution 

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.)

                    (Check the applicable statement. This Form LLC-3 is not required when the vote to dissolve was made by all of the members
3. Dissolution      and that fact is noted on the Certificate of Cancellation (Form LLC-4/7).) 

The dissolution of this LLC was caused by one of the following circumstances (check one): 

           The happening of an event as set forth in the Articles of Organization or in the LLC’s written Operating 
           Agreement. 

           The vote of 50 percent or more of the voting interests of the members of the LLC or a greater percentage of 
           the voting interests of members as specified in the Articles of Organization or written Operating Agreement. 

           The passage of 90 consecutive days during which the LLC has no members, except on the death of a natural 
           person who is the sole member of the LLC, the status of the member, including a membership interest, may 
           pass to the heirs, successors and assigns of the member by will or applicable law. 

           The entry of a decree of judicial dissolution pursuant to California Corporations Code section 17707.03. 

      The Certificate of Dissolution puts all on notice that the LLC has elected to wind up the business of the LLC and is 
      in the process of paying liabilities and distributing assets.  In order to terminate the LLC, the LLC also must file a 
      Certificate of Cancellation (Form LLC-4/7). 

4. 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-3 (REV 03/2022)                   Clear Form          Print Form                           20 22California Secretary of State 
                                                                                                    bizfileOnline.sos.ca.gov 

                                                                      LLC-4/7
                     Secretary of State 
                     Certificate of Cancellation 
                     Limited Liability Company (LLC) 

There is No Fee for filing a Certificate of Cancellation 

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. Dissolution (California LLCs ONLY: Check the box if the vote to dissolve was made by the vote of ALL the members.)

   The dissolution was made by a vote of ALL of the members of the California Limited Liability Company. 

   Note:  If the above box is not checked, a Certificate of Dissolution (Form LLC-3) must be filed prior to or together with this 
   Certificate of Cancellation.  (California Corporations Code section 17707.08(a).) 

4. Tax Liability Statement (Do not alter the Tax Liability Statement.)

All final returns required under the California Revenue and Taxation Code have been or will be filed with the California 
Franchise Tax Board. 

5. Cancellation Statement (Do not alter the Cancellation Statement.)

Upon the effective date of this Certificate of Cancellation, the Limited Liability Company’s registration is cancelled and its 
powers, rights and privileges will cease in California. 

6. 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 

  ________________________________________________________________            ________________________________________________  
   Signature                                                                     Type or Print Name 

LLC-4/7 (REV 03/2022)                        Clear Form               Print Form                       20 22California Secretary of State 
                                                                                                                     bizfileOnline.sos.ca.gov 

              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