ANNUAL REPORT
Secretary of State Office
500 E Capitol Ave
FILE DATE
____________________
DOMESTIC LLP
Pierre, SD 57501
RECEIPT NO ___________________
(605)773-4845
Please Type or Print Clearly in Ink
FILING FEE: $50
SECRETARY OF STATE
Make check payable to
Clear Form
1
L.L.P. ID and Name:
.
HELP
Search for Corporate ID, Name and Agent
Telephone # ____________________
FAX #
_______________________
FILING DATE: Due during the
anniversary month of Registration and
delinquent after the last day of the
following month.
South Dakota
2. The jurisdiction under whose law it is formed __________________________________________________________
3. The address of the principal or chief executive office.
______________________________________________________________________________________________
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional)
City
State
ZIP+4
IF ADDRESS IN #3 IS NOT A SOUTH DAKOTA ADDRESS QUESTION #4 IS REQUIRED.
4. The name of the South Dakota Registered Agent _______________________________________________________
______________________________________________________________________________________________
Street Address (Required to be a South Dakota Address)
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional – Required to be a South Dakota Address)
City
State
ZIP+4
5. The names and business addresses of its partners.
______________________________________________________________________________________________
Partner
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Partner
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Partner
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Partner
Street Address
City
State
ZIP+4
No person may execute this report knowing it is false in any material respect. Any violation is subject to a civil penalty.
Dated ____________________________
______________________________________________
(Signature of an Authorized Person)
______________________________________________
(Printed Name)
annualreportllp July 2010