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Illinois Uniform Limited Partnership Act
LP 810/906.5
Form
FILE #:
Application for Reinstatement
June 2010
This space for use by Secretary of State.
Secretary of State
Department of Business Services
SUBMIT IN DUPLICATE
Limited Liability Division
Please type or print clearly.
501 S. Second St., Rm. 357
Springfield, IL 62756
This space for use by Secretary of State.
217-524-8008
Filing Fee: $200
Approved:
Correspondence regarding this filing will be sent to
the registered agent of the Limited Partnership un-
less a self-addressed, stamped envelope is included.
1. Limited Partnership Name:________________________________________________________________
____________________________________________________________________________________
2. Jurisdiction:______________________________________________________________________________
3. Federal Employer Identification Number (F.E.I.N.): ____________________________________________
4. Date of Dissolution/Revocation:__________________________________________________________________
5. Registered Agent:______________________________________________________________________________
Name
Registered Office: ____________________________________________________________________________
Street Address
City, State, ZIP
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.
Dated: __________________________________
________________________________________
Month, Day Year
General Partner Name if corporation or other entity
________________________________________
__________________________________________
Signature
Name and Title (type or print)
Dated: __________________________________
__________________________________________
Month, Day Year
General Partner Name if corporation or other entity
Signatures must be in BLACK INK on an original document.
Carbon copy, photocopy or rubber stamp signatures
may only be used on conformed copy.
♻ Printed on recycled paper. Printed by authority of the State of Illinois. August 2010 — 200 — C LP 25.3
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