Form Knl - Statement Of Qualification (Domestic Limited Liability Partnership)

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C
K
OMMONWEALTH OF
ENTUCKY
A
L
G
, S
S
LISON
UNDERGAN
RIMES
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Business Filings
Statement of Qualification
KNL
Business Filings
(Domestic Limited Liability Partnership)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS 14A and KRS 362.1, the undersigned partnership submits the following statement:
1. Name of the partnership electing to be a limited liability partnership is:
________________________________________________________________________________________________.
2. The name of the entity to be used in Kentucky is (if applicable):____________________________________________.
(Only provide if "real name" is unavailable for use; otherwise, leave blank.)
3. The mailing address of principal office of the limited liability partnership is:
_________________________________________________________________________________________________
Street Address or Post Office Box Numbers
City
State
Zip Code
4. The mailing address/chief executive office of any partnership office in Kentucky (if any) is:
_________________________________________________________________________________________________
Street Address or Post Office Box Numbers
City
State
Zip Code
5. The street address of the partnership’s initial registered office in Kentucky is:
_________________________________________________________________________________________________
Street Address (No Post Office Box Numbers)
City
State
Zip Code
6. The name of the initial registered agent at that office is:
________________________________________________________________________________________________.
7. The above partnership elects to be a limited liability partnership.
8. The partnership previously filed a Statement of Authority with the Secretary of State on________________________.
Date
9. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date
or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is______________.
(Delayed effective date
and/or time)
We declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
_______________________________ ___________________________ _____________________
Signature of Partner
Printed Name
Date
_______________________________ ___________________________ _____________________
Signature of Partner
Printed Name
Date
I, _____________________________________, consent to serve as the registered agent on behalf of the limited liability
partnership.
________________________________________________________________ ________________________________________ ________________
Signature of Registered Agent
Printed Name
Date
(01/12)

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