Instructions: Combined Statement of Conversion

Entity ID Number

The ID Number field will be prefilled with the 11-digit number assigned to the record by our office, if applicable. The resulting entity will have the same entity ID number as the converting entity.

Resulting Entity Information

The first fields relate to the entity as it will exist after the conversion.  These fields are as follows:

Entity Name

This field is prefilled with the name that you entered. If the name is incorrect, scroll to the bottom and click on “Previous Page”.  This will take you back to the Name Availability Search page.  Enter the correct name.

Form of Entity

The form field will be prefilled with the form of the entity selected from the Conversion page.

If the entity form is incorrect, return to the Conversion page and select the correct entity form. To return to the Conversion page, click on “Previous Page” on Statement of Conversion page and then click on “Previous Page” on the Resulting Entity Name Availability Search page

Jurisdiction of Entity

The jurisdiction field will be prefilled with “Colorado”. If Colorado is not the jurisdiction of formation for the resulting entity, return to the Conversion page and select a different form from the list.  To return to the Conversion page, click on “Previous Page” on the Statement of Conversion page and then click on “Previous Page” on the Resulting Entity Name Availability Search page.

Converting Entity Information

The next series of fields relate to the entity as it exists before the conversion. These fields are as follows:

Entity Name

The entity name will be prefilled with the name that is on record with our office. 

Form of Entity

The form will be prefilled with the form of the converting entity as it is on record in our office.

Jurisdiction of Entity

The jurisdiction field will be prefilled with the converting entity’s jurisdiction of formation that is on record in our office.

Principal Office Address

The principal office address of the converting entity may have been prefilled. You can edit this information.

Street Address (required)

Enter the street address. Include the suite, unit or apartment number, if applicable. If the address is outside of the United States, include the country and province (if applicable).

Example:

123 N. Main Street, Apt 101
Denver, Colorado 80202

Mailing Address (optional)

A mailing address is optional. If the mailing address is different from the street address, or mail cannot be delivered to the street address, enter the address where mail is to be delivered. If the address is outside of the United States, include the country and province (if applicable).

Example:

P.O. Box 854
Lakewood, Colorado 80228

Mailing Address same as Street Address

If the mailing address is the same as the street address, or the mailing address is no longer valid, mark “Yes”.

Statement Regarding Conversion

A statement is required that the converting entity has been converted into the resulting entity. [1]

Additional Information

Mark “Yes” if you will be attaching additional information to the form.  You will have a chance to add attachments after you have finished filling out the form and clicked on “Submit”. Attachments can be text (.txt) or PDF (.pdf) files. Information about attachments.

 

Review the form carefully; mistakes may have legal consequences. Our office cannot provide legal advice. Questions should be addressed to your legal, business or tax advisor(s). Only provide information that is required or permitted to be included in the document. Information included in the document must be in English, and must state the name and address of at least one individual causing the document to be delivered for filing.

 Statement of Conversion filed pursuant to § 7-90-201.7 (3), C.R.S.

 

[1] 7-90-201.7, C.R.S.