L-209 NJSA 42 
(7/03) 

                                  New Jersey Division of Revenue 

                                   Certificate of Withdrawal 
                                    Limited Liability Partnership 
                                                
This form may be used to withdraw a registration of a Limited Liability Partnership on file with the 
Division of Revenue. Applicants must insure strict compliance with NJSA 42, and insure that all 
applicable filing requirements are met. 
 
1. Name of Limited Liability Partnership: 
 
2.  Business Entity Number: 
 
3.  Date of formation: 
 
4.  State of Formation (Foreign entities only) 
 
5.  Effective date of withdrawal: 
 
6.  Reasons for withdrawing the LLP:   
 
The undersigned represent(s) that this filing complies with State law as detailed in NJSA 42 and that they 
are authorized to sign this form on behalf of the Limited Liability Partnership. 
 
Signature:                                      Date:
 
Name: 
 
                       NJ  Division of Revenue, PO Box 308, Trenton NJ 08625 

Rev 7/0 5
                         
                                  Instructions for Form L-209 
                                            
                             CERTIFICATE OF WITHDRAWAL 
          DOMESTIC AND FOREIGN LIMITED LIABILITY PARTNERSHIPS 
                                            (Title 42) 
 
STATUTORY FEE:  $100 
The MANDATORY fields are:  
 
Field # 1 -- Business Name 
        List the name as it appears on the records of the State Treasurer. 
     
Field # 2 – Business Entity Number 
         Provide the 10-digit business entity identification number issued by the State of New 
         Jersey. 
 
Field # 3 – Date of Formation 
         List the date the LLP was formed. 
 
Field # 4 –State of Formation  
         List the state where the LLP was formed.  Required for foreign entities only. 
 
Field # 5 – Effective Date Of Cancellation 
         Specify the effective date if it is other than the filing date.  The effective date cannot be 
         before the filing date nor can it be more than 30 days after the filing date.  The filing date 
         is the date the document is received for processing. 
 
Field # 6 -- Reason For Filing 
       Specify the reason for filing the withdrawal. 
     
ATTESTATIONS 
     Add a statement that indicates that the signers are authorized to sign on behalf of the LLP. 
     Form L-109 provides the statement. 
      
EXECUTION (DATE/SIGNATURE) 
    An authorized partner, or a majority of partners in interest, must sign. Also, list the 
    date of execution (signature).  
     
                                    * * * * * * * * * * * * * * * * 
These documents should be filed in duplicate.  Non-profits should file in triplicate. 
All annual report obligations should be satisfied prior to submitting the dissolution paperwork. 
 
Make checks payable to:  TREASURER, STATE OF NEW JERSEY.   (No cash, please) 
 
Mail to: NJ Division of Revenue, PO Box 308, Trenton, NJ  08646