Statement Of Qualification (Limited Liability Partnership) Form - Department Of Commerce - 2014

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State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Statement of Qualification (Limited Liability Partnership)
Print
Clear Form
Instructions
Important: Read instructions before completing form.
Non-Refundable Processing Fee: $22.00
1. Limited Liability Partnership Name:
(see instructions for name requirements)
2. Principal office (street address):
________________________________________________________________________________________
Address
City
State
Zip
3. The name of the Registered Agent (Individual or Business Entity or Commercial Registered Agent):
________________________________________________________________________________________
The address must be listed if you have a non-commercial registered agent. See instructions for further details.
___________________________________________________________
Address of the Registered Agent:
Utah Street Address Required, PO Boxes can be listed after the Street Address
City:
State UT
Zip:
4. This partnership elects to become a Limited Liability Partnership.
5a. Authorized Partner:
Name: _______________________________________________________________
(Partners are optional)
_______________________________________________________________
Street Address
______________________________________________________________________________________________
City
State
Zip
5b. Authorized Partner:
Name: _______________________________________________________________
(Partners are optional)
_______________________________________________________________
Street Address
Attach additional pages if needed to list
more partners
______________________________________________________________________________________________
City
State
Zip
6.
Under penalties of perjury, I declare that this Certificate of Limited Liability Partnership has been examined by me and is, to the best of my
knowledge and belief, true, correct, and complete.
Sign here after the form is printed
Signature:
Name & Title:
7. Purpose of the Limited Liability Partnership:
(optional)
Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes, you may
use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
Optional Inclusion of Ownership Information: This information is not required.
Is this a female owned business?
Yes
No
Select/Type the race of the owner here
Is this a minority owned business?
Yes
No
If yes, please specify:
/contactus.html
Division's Website:
Mailing/Faxing Information:
01/14

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