Form Lp 109 - Application To Reserve Name Or Transfer Reserved Name Page 2

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TRANSFER RESERVED NAME
The undersigned __________________________________________________________________________
Original Applicant Name
hereby transfers to ________________________________________________________________________
Transferee Name
the right to use the name ___________________________________________________________________
for Limited Partnership purposes in Illinois.
This name was reserved on _________________________________________________________________
Date (month, day, year)
The undersigned affirms, under penalties of perjury, that the facts stated herein are true, correct and complete.
Date: ____________________________________
Month, Day, Year
________________________________________
Signature
________________________________________
Name and Title (type or print)
________________________________________
General Partner Name and Title if a Limited Partnership
________________________________________
__________________________________________
City, State, ZIP, County
Name and title (type or print)
Signatures must be in black ink on an original document.
Carbon copy, photocopy or rubber stamp signatures
may only be used on conformed copies.

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