Form Lp 810/906.5 - Application For Reinstatement - Illinois Secretary Of State

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DO NOT STAPLE
Form LP 810/906.5
January 2008
Filing Fee: $200
Submit in duplicate. Payment must be
made by certified check, cashier’s check,
Illinois attorney’s check, Illinois C.P .A.’s
check or money order, payable to
Secretary of State.
Please do not send cash.
Department of Business Services
Limited Liability Division
501 S. Second St., Rm 357
Springfield, IL 62756
217-785-8960
Correspondence regarding this filing will
Illinois Secretary of State
be sent to the registered agent of the
Limited Partnership unless a self-
Department of Business Services
addressed, stamped envelope is
included.
Application for Reinstatement
Please type or print clearly.
1. Limited Partnership Name: ______________________________________________________________________
______________________________________________________________________________________________
2. File Number assigned by Secretary of State: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Jurisdiction: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3. Federal Employer Identification Number (F.E.I.N.)____________________________________________________
4. Date of Dissolution/Revocation: ____________________________________________________________________________
5. Registered Agent: __________________________________________________________________________________________
Street Address
Registered Office: ________________________________________________________________________________________
City, State, ZIP , County
This application is accompanied by all amendments necessary to change existing information, all delinquent
reports and information requirements, and all required fees.
I affirm, under penalties of perjury, having authority to sign hereto, that this reinstatement is to the best of my
knowledge and belief, true, correct and complete. Must be signed by a General Partner on record.
Date (month, day, year)
Name & Title (type or print)
Signature
General Partner Name if a company or other entity
Signatures must be in BLACK INK on an original document.
Carbon copy, photocopy or rubber stamp signatures my only be used on conformed copy.
Printed by authority of the State of Illinois. January 2008 — 200 — C LP 25.2

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