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Application For Qualification Of Limited Liability Partnership - Arkansas Secretary Of State

Arkansas Secretary of State

ark

artin

State Capitol • Little Rock, Arkansas 72201-1094

501-682-3409 •

Business & Commercial Services, 250 Victory Building, 1401 W. Capitol, Little Rock

APPLICATION FOR QUALIFICATION OF LIMITED LIABILITY

PARTNERSHIP

(Under Act 1518 of 1999)

(PLEASE TYPE OR PRINT CLEARLY IN INK)

1. The name of the limited liability partnership is: ________________________________________________________

2a. The street address of the chief executive office of the limited liability partnership is: ___________________________

_____________________________________________________________________________________________

2b. The street address of an office in Arkansas, if different from the chief executive office: _________________________

_____________________________________________________________________________________________

3. If there is no office in Arkansas, the name and street address of the agent for service of process for the limited liability

partnership who is also an Arkansas resident or has authority to do business in Arkansas is: ____________________

_____________________________________________________________________________________________

4. Statement of intent to be a limited liability partnership: __________________________________________________

_____________________________________________________________________________________________

5. Deferred effective date, if any: _____________________________________________________________________

I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class

C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days.

Authorizing Officers ________________________________________________________________________________

(Type or Print)

Authorized Signature ____________________________________

______________________________________

(Partner)

(Date)

Authorized Signature ____________________________________

______________________________________

(Date)

(Partner)

$50.00 Filing Fee payable to Arkansas Secretary of State

Rev. 3/08

Application For Qualification Of Limited Liability Partnership - Arkansas Secretary Of State