Form Lp 210 - Annual Report - Illinois Uniform Limited Partnership Act
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Illinois Uniform Limited Partnership Act
LP 210
Form
Annual Report
FILE #:
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
This space for use by Secretary of State.
Springfield, IL 62756
217-524-8008
Filing Fee: $100
Approved:
Correspondence regarding this filing will be sent to
Payment must be made by check
the registered agent of the Limited Partnership un-
payable to Secretary of State.
less a self-addressed, stamped envelope is included.
Please do not send cash.
Do not make changes on this form. To change the Agent and/or Designated Office, sub-
mit Form LP 115 along with the $50 filing fee. For all other changes, submit LP 202 (Illi-
nois) or LP 902.5 (foreign) along with the $50 filing fee.
1. Limited Partnership Name: __________________________________________________________________
2.
Address of Office at which records required by Section 111 (Illinois) or Section 902 (Foreign) are kept:
________________________________________________________________________________________
Street Address (P.O. Box alone is unacceptable.)
________________________________________________________________________________________
City, State, ZIP
3.
Federal Employer Identification Number (F.E.I.N.): ____________________________________________
4.
Assumed Name, if any: __________________________________________________________________
5.
Registered Agent: ______________________________________________________________________
Name
Registered Office:______________________________________________________________________
Street Address (P.O. Box alone is unacceptable.)
____________________________________________________________________________________
City, State, ZIP
6.
State or Jurisdiction of Organization: ________________________________________________________
The Annual Report must be signed by a General Partner. I affirm that any entity serving as a General Partner
for this Limited Partnership is in good standing in its home state. The undersigned affirms, under penalties of per-
jury, that the facts stated herein are true, correct and complete.
Date: ____________________________________
__________________________________________
Month, Day, Year
General Partner Name if a corporation or other entity
________________________________________
__________________________________________
Signature
Name and Title (type or print)
Date: ____________________________________
__________________________________________
Month, Day, Year
General Partner Name if a corporation or other entity
(must be in good standing)
Signatures must be in black ink on an original document.
♻ Printed on recycled paper. Printed by authority of the State of Illinois. August 2010 — 200 — C LP 12.11
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