Form Dscb:15-8221/8998 - Certificate Of Annual Registration - 2016

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PENNSYLVANIA DEPARTMENT OF STATE
BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS
Return document by mail to:
Name
Address
City
State
Zip Code
Return document by email to:
_________________________________
Read all instructions prior to completing. This form may be submitted online at https://
Fee: See Instructions C and E.
Check one:
Registered Limited Liability Partnership (§ 8221)
Restricted Professional Limited Liability Company (§ 8998)
In compliance with the requirements of the applicable provisions (relating to annual registration), the
undersigned domestic or foreign registered limited liability partnership/restricted professional limited liability company,
hereby states that:
1. The name of the registered limited liability partnership/restricted professional limited liability company is:
Limited Liability Partnership: complete only paragraph 2
2. The prescribed annual base fee of $350 times
(the number of persons who were general partners of
this partnership on December 31,
(year) and who are described in § 8221(b)(1)) accompanies this
Certificate of Annual Registration.
Restricted Professional Limited Liability Company: complete only paragraphs 3 and 4
3. Check one of the following:
The company engaged only in business permitted by § 8996(a) (relating to purposes of restricted
professional companies) during the year with respect to which this certificate is being filed.
The company engaged in business not permitted by § 8996(a) (relating to purposes of restricted
professional companies) during the year with respect to which this certificate is being filed.
4. The prescribed annual base fee of $520 times
(the number of persons who were members of this
company on December 31,
(year) and who are described in § 8998(b)(1)) accompanies this
Certificate of Annual Registration.
IN TESTIMONY WHEREOF, the undersigned general partner/
member has executed this Certificate of Annual Registration this
______ day of
,
.
Signature

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