Form Fnl - Statement Of Foreign Qualification - Commonwealth Of Kentucky

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C
K
OMMONWEALTH OF
ENTUCKY
A
L
G
, S
S
LISON
UNDERGAN
RIMES
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of
Business Filings
Statement of Foreign Qualification
FNL
Business Filings
(Foreign Limited Liability Partnership)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS 14A and KRS 362.1, the undersigned applies to qualify and for that purpose submits the following
statement:
1. The name of the foreign limited liability partnership is ______________________________________________________________.
2. The name of the entity to be used in Kentucky is (if applicable):______________________________________________________.
(Only provide if "real name" is unavailable for use; otherwise, leave blank.)
3. The mailing address of the partnership’s principal office address is:
_____________________________________________ _________________________ ____________ ___________.
Street Address or Post Office Box Numbers
City
State
Zip
4. The mailing address of the principal office address of any partnership office in Kentucky (if applicable):
_____________________________________________ _________________________ ____________ ___________.
Street Address or Post Office Box Numbers
City
State
Zip
5. The street address of the partnership’s initial registered office in Kentucky is
_____________________________________________ _________________________ ____________ ___________.
Street Address (No Post Office Box Numbers)
City
State
Zip
6. The name of the initial registered agent at that office is _____________________________________________________________.
7. The state or country of jurisdiction of the organization is____________________________________________________________.
8. This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date or the
delayed effective date cannot be prior to the date the application is filed. The date and/or time is ______________________________.
(Delayed effective date and/or time)
I/We declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
_________________________________________ ______________________________ _________________
Signature of Partner
Printed Name
Date
________________________________________________________ ________________________________________ _______________________
Signature of Partner
Printed Name
Date
I, ______________________________________________________, consent to serve as the registered agent on behalf of the limited
liability partnership.
_______________________________________________________ _________________________________________ _______________________
Signature of Registered Agent
Printed Name
Date
(01/12)

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