Form Dscb:15-8201a - Statement Of Registration - Domestic Registered Limited Liability Partnership
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3PENNSYLVANIA 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.
Fee: $125
I qualify for a veteran/reservist-owned small business fee exemption (see instructions)
In compliance with the requirements of 15 Pa.C.S. § 8201 (relating to statement of registration), the undersigned
general partnership or limited partnership, desiring to register as domestic limited liability partnership or limited liability
limited partnership, hereby certifies that:
1. The name of the domestic limited liability partnership or limited liability limited partnership is (designator is required,
i.e., “company,” “limited” or “limited liability partnership” or abbreviation):
2. Check and complete one of the following:
The partnership is a general partnership and the address, including number and street, if any, of its principal place
of business is:
Number and street
City
State
Zip
County
The partnership is a limited partnership and the (a) address of its current registered office in this Commonwealth
or (b) name of its commercial registered office provider and the county of venue is: (Complete (a) or (b), not both)
(a) Number and Street
City
State
Zip
County
c/o:
(b) Name of Commercial Registered Office Provider
County
3. The general/limited (strike out inapplicable term) partnership registers under 15 Pa.C.S. Chapter 82 Subchapter A.
4. The registration has been authorized by at least a majority in interest of the partners.
5. Effective date of Statement of Registration (check, and if appropriate complete, one of the following):
The Statement of Registration shall be effective upon filing in the Department of State.
The Statement of Registration shall be effective on: _________________________ at __________________.
Date (MM/DD/YYYY)
Hour (if any)
IN TESTIMONY WHEREOF, the undersigned general partner of the domestic limited liability partnership/limited
liability limited partnership has executed this Statement of Registration this ______ day of _______________, ________.
________________________________________________________
Name
________________________________________________________
Signature
________________________________________________________
Title
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