Instructions: Statement of Conversion

 Use these instructions when completing a Statement of Conversion pursuant to § 7-90-201.7 (1) of the Colorado Revised Statutes (C.R.S.). The required form/cover sheet must be used when submitting the document for filing. Mistakes may have legal consequences: review the information provided carefully. The Colorado Secretary of State’s 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, typewritten or machine printed, and must state the name and address of at least one individual causing the document to be delivered for filing. In order to obtain a copy of the filed document or access additional information, including Frequently Asked Questions (FAQs), visit our Web site, www.sos.state.co.us.

 

Instructions

Note: If the pre-filled information is incorrect and cannot be changed using this form, the appropriate form must be submitted for filing to change or correct the information.

Converting Entity Information: The initial fields relate to the entity as it exists prior to the conversion. These fields are as follows:

Entity ID Number: The ID Number field will be pre-filled with the 11 digit number assigned to the record by the Colorado Secretary of State’s Office. This information cannot be changed.

Entity Name: The Entity Name field will be pre-filled with the name of the converting entity exactly as such name is on record in the Colorado Secretary of State’s Office. This information cannot be changed using this form. 

Form of Entity: The Form field will be pre-filled with the form of the converting entity exactly as such form is on record in the Colorado Secretary of State’s Office. This information cannot be changed using this form.

Jurisdiction of Entity: The Jurisdiction field will be pre-filled with the converting entity’s jurisdiction of formation exactly as such jurisdiction is on record in the Colorado Secretary of State’s Office. This information cannot be changed using this form.

Principal Office Address: The principal office address of the converting entity may have been pre-filled. You may edit this information.

Principal Office Street Address: A street address is required. Provide the street name and number, including the suite, unit or apartment number, if applicable. The city, state, and ZIP/postal code must also be provided. Any address outside of the United States must include the country and, if applicable, the province.

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

Principal Office Mailing Address: A mailing address is optional. If the mailing address is different than the street address, or mail cannot be delivered to the street address, provide the address, including the city, state and ZIP/postal code where mail is to be delivered. Any address outside of the United States must include the country and, if applicable, the province.

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, click the “Yes” button.

Resulting Entity Information: The next series of fields relate to the entity as it will exist after the conversion.  These fields are as follows:

True Name: Provide the true name of the resulting entity. For legal authority, refer to § 7-90-601, C.R.S.

Form of Entity: Select the form of the resulting entity from the drop-down list.

Jurisdiction of Entity: The Jurisdiction field will be pre-filled with “Colorado”. If Colorado is not the jurisdiction of formation for the resulting entity, click on “Previous Page” and select a different form from the list that does not result in a domestic entity.

Principal Office Address: The principal office address of the resulting entity may have been pre-filled. You may edit this information.

Principal Office Street Address: A street address is required. Provide the street name and number, including the suite, unit or apartment number, if applicable. The city, state, and ZIP/postal code must also be provided. Any address outside of the United States must include the country and, if applicable, the province.

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

Principal Office Mailing Address: A mailing address is optional. If the mailing address is different than the street address, or mail cannot be delivered to the street address, provide the address, including the city, state and ZIP/postal code where mail is to be delivered. Any address outside of the United States must include the country and, if applicable, the province.

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, click the “Yes” button.

Statement Regarding Conversion: A statement is required that the converting entity has been converted into the resulting entity pursuant to § 7-90-201.7, C.R.S.

Additional Information: Click the “Yes” button if additional information is permitted or required by law to be included in the document. After clicking on “Submit” at the bottom of the online form, the Manage Attachments page will appear. This will allow additional information to be attached as a plain text (.txt) or PDF (.pdf) document.

Information about attachments.

Delayed Effective Date (optional): Leave this field blank if you want the document to take effect immediately. However, the effective date of this document may be delayed up to 90 days after filing with the Colorado Secretary of State’s Office.  If you do not want the document to become effective immediately, enter the date and, if appropriate, time that you want the document to become effective in the box.  If only a date is entered into the box, then the document becomes effective at twelve midnight on that date. Mountain Time controls the filing date and time. For legal authority, refer to § 2-4-109 and § 7-90-304, C.R.S.

Notice: This section describes the legal authority for filing this document. Refer to § 7-90-301.5, C.R.S. for more information.

Individual Causing Delivery: Pursuant to § 7-90-301.5, C.R.S., each individual causing the document to be filed is responsible for complying with the applicable statutes. Provide the last name and first name of at least one individual causing the document to be delivered for filing. A middle name or initial and a suffix are optional. The mailing address, including the city, state and ZIP/postal code, must be provided. Any address outside of the United States must include the country and, if applicable, the province.

Example: Smith, John
               123 N. Main St., Apt 101
               Denver, Colorado 80122

Additional Individuals Causing Delivery: Click the “Yes” button to include an attachment with the names and addresses of additional individuals causing the document to be filed. The attachment must provide the name of each additional individual, including their last name and first name. A middle name or initial and a suffix are optional. Also provide the mailing address, including the city, state and ZIP/postal code. Any address outside of the United States must include the country and, if applicable, the province.

Disclaimer: These instructions, and the related form/cover sheet, are not intended to provide legal, business or tax advice, and are offered as a public service without representation or warranty. While the related form/cover sheet is believed to satisfy minimum legal requirements as of its revision date, compliance with applicable law, as the same may be amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should be addressed to the user’s attorney.