Form Llp-1 - Statement Of Registration Of Domestic Or Foreign Limited Liability Partnership Page 2

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STATEMENT OF REGISTRATION OF DOMESTIC OR FOREIGN LIMITED LIABILITY PARTNERSHIP
Page 2
10. Signature information*
(To be signed by one or more partners)
I, the undersigned, acting as authorized partner on behalf of the partnership, do hereby affirm that the
partnership has determined to register as a limited liability partnership, that the partnership will, as
required by West Virginia Code §47B-10-5, carry at all times at least one million dollars of liability
insurance, and that the information contained in this application is true, to the best of my knowledge.
Date
Name
Signature
__________________ ______________________________ ______________________________
__________________ ______________________________ ______________________________
__________________ ______________________________ ______________________________
__________________ ______________________________ ______________________________
*Important Legal Notice Regarding Signature: Per West Virginia Code §31B-2-209. Liability for false
Statement in filed record. If a record authorized or required to be filed under this chapter contains a false
Statement, one who suffers loss by reliance on the Statement may recover damages for the loss from a person who
signed the record or caused another to sign it on the person's behalf and knew the Statement to be false at the time
the record was signed.
Form LLP-1
Issued by the Office of the Secretary of State
Revised 5/13

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