Limited Partnership Uniform Business Report (Ubr) Form - Division Of Corporations Florida
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1
2LIMITED PARTNERSHIP
UNIFORM BUSINESS REPORT (UBR)
DOCUMENT #
1. Entity Name
DO NOT WRITE IN THIS SPACE
2. Principal Place of Business
3. Mailing Address
DO NOT WRITE IN THIS SPACE
Suite, Apt. #, etc.
Suite, Apt. #, etc.
DUE BY MAY 1
City & State
City & State
Applied For
4. FEI Number
Not Applicable
Zip
Country
Zip
Country
$8.75
Additional
5. Certificate of Status Desired
Fee Required
7. Name and Address of Current Registered Agent
Name
DO NOT WRITE
Street Address (P.O. Box Number is Not Acceptable)
IN THIS SPACE
City
Zip Code
FL
8. The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida.
SIGNATURE
Signature, typed or printed name of registered agent and title if applicable.
DATE
9. Capital Contributions
10. Amount of Capital Contributions
MAKE CHECK PAYABLE TO DEPT. OF STATE
11.
as Shown on record.
in FLORIDA to date.
SEE REVERSE SIDE FOR FEE INFORMATION
A GENERAL PARTNER THAT IS A BUSINESS ENTITY MUST BE REGISTERED AND ACTIVE WITH THIS OFFICE.
NOTE: General Partners MAY NOT be changed on the form; an amendment must be filed to change a general partner.
12.
GENERAL PARTNER INFORMATION
DOCUMENT #
STREET ADDRESS
NAME
STREET ADDRESS
CITY- ST- ZIP
CITY- ST- ZIP
DOCUMENT #
STREET ADDRESS
NAME
STREET ADDRESS
CITY- ST- ZIP
CITY- ST- ZIP
DOCUMENT #
STREET ADDRESS
NAME
STREET ADDRESS
DO NOT WRITE
CITY- ST- ZIP
CITY- ST- ZIP
DOCUMENT #
IN THIS SPACE
STREET ADDRESS
NAME
STREET ADDRESS
CITY- ST- ZIP
CITY- ST- ZIP
DOCUMENT #
STREET ADDRESS
NAME
STREET ADDRESS
CITY- ST- ZIP
CITY- ST- ZIP
DOCUMENT #
STREET ADDRESS
NAME
STREET ADDRESS
CITY- ST- ZIP
CITY- ST- ZIP
14. I hereby certify that the information supplied with this filing does not qualify for the exemption stated in Section 119.07(3)(i), Florida Statutes. I further certify that the information
indicated on this report is true and accurate and that my signature shall have the same legal effect as if made under oath; that I am a General Partner of the limited partnership or
the receiver or trustee empowered to execute this report as required by Chapter 620, Florida Statutes
SIGNATURE:
SIGNATURE AND TYPED OR PRINTED NAME OF SIGNING GENERAL PARTNER
Date
Daytime Phone #
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