Conversion Corporation in LLC/ Convertir Corporation a LLC

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Company Name / Nombre de la Empresa *

Email *

Phone Number *

Type of Entity / Tipo de Company *

Company Document Number / Numero de Inscripcion *

Date of Incorporate / Fecha de Inscripcion *

EIN / Federal Tax ID *

Name of Corporation President / Name del Presidente de la Corporation a convertir *

First

Last

Signature of Corporation President / Firma del Presidente de la Corporation a convertir *

Name of Corporation Vice President / Firma del Vice Presidente de la Corporation a convertir *

First

Last

Signature of Corporation Vice President / Firma del Vice Presidente de la Corporation a convertir *

Name of Florida Limited Liability Company ( LLC) *

Address of New LLC / Direccion LLC Company *

Line 1

Line 2

City

State

Zip Code

Country

Name of Manager of LLC /Nombre Manager de la LLC *

First

Last

Address of Manager of LLC /Direccion Manager de LLC *

Line 1

Line 2

City

State

Zip Code

Country

Social Security / Social Security *

Email *

Phone Number *

Name of Vice Manager of LLC /Nombre Vice Manager de la LLC *

First

Last

Address of Vice Manager of LLC /Direccion Vice Manager de la LLC *

Line 1

Line 2

City

State

Zip Code

Country

Social Security / Social Security *

Additional Comment / Comentarios Adicionales *

Signature ( Member Authorizided ) / Firma del Miembro Autorizado *

Date Efective *

Terms and Conditions

Agree / Acepto *

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