Secretary of State Office
STATEMENT OF QUALIFICATION
500 E Capitol Ave
Pierre, SD 57501
Clear Form
OF A FOREIGN
(605)773-4845
LIMITED LIABILITY PARTNERSHIP
Please Type or Print Clearly in Ink
Original
Photocopy
Please submit one
and one
FILING FEE: $125
SECRETARY OF STATE
payable to
Telephone # ____________________
FAX #
_______________________
1. The name of the limited liability partnership is __________________________________________________________
_______________________________________________________________________________________________
The name shall contain the words “Registered Limited Liability Partnership”, or “Limited Liability Partnership”, or “R.L.L.P.” or
“L.L.P.”, or “RLLP”, or “LLP” as the last words of the name.
2. The state of its formation_____________________________
3. The date of its formation______________________________
4. The street address of its chief executive office
_______________________________________________________________________________________________
Street Address
City
State
ZIP+4
_______________________________________________________________________________________________
Mailing Address (Optional)
City
State
ZIP+4
5. The South Dakota Registered Agent name ____________________________________________________________
_______________________________________________________________________________________________
Street Address or Rural Route Box Number in This State and
City
State
ZIP+4
_______________________________________________________________________________________________
Mailing Address in This State, if Different from Street Address
City
State
ZIP+4
When listing a Commercial Registered Agent, please state their CRA #.
This number can be obtained from the Commercial Registered Agent.
________________________________
6. The deferred effective date of the registration if it is not to be effective upon filing of the registration
_____________________________________________