Limited Partnership Reinstatement

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LIMITED

FLORIDA DEPARTMENT OF STATE

PARTNERSHIP

Secretary of State

REINSTATEMENT

DIVISION OF CORPORATIONS

DOCUMENT #

Name of Limited Partnership

Principal Office Address - No P.O. Box #

Mailing Office Address

CR2E039 (1/11)

Suite, Apt. #, etc.

Date Formed or Registered

To Do Business in Florida

City & State

Applied For

FEI Number

Not Applicable

Zip

Country

Zip

Country

$8.75

Additional Fee required

CERTIFICATE OF STATUS DESIRED

for a Certificate of Status

7. FEES:

Name and Address of Current Registered Agent

Filing Fee(s): $411.25 for each year due this office.

Name

Supplemental Fee(s): $88.75 for each year due this office.

Street Address (P.O. Box Number is Not Acceptable)

Penalty Fee(s): $500 for each year or part thereof limited

partnership revoked on our records.

___________________________________________________

Suite, Apt. #, Etc.

E-mail Address:

Zip Code

City

___________________________________________________

E-Mail address to be used for future annual report notices.

Pursuant to the provisions of section 620.1810 or 620.1909, Florida Statutes, I hereby accept the appointment of registered agent. I am familiar with, and accept the obligations of Chapter 620,

Florida Statutes.

SIGNATURE (Registered Agent Accepting Appointment)

DATE

________________________________________________________________________________________________________________________________

___________________________________________________

(REGISTERED AGENT MUST SIGN)

A GENERAL PARTNER THAT IS A CORPORATION, LIMITED PARTNERSHIP OR OTHER BUSINESS ENTITY

MUST BE REGISTERED AND ACTIVE WITH THIS OFFICE.

Address of Each General Partner

Registration

10.

10a.

City, State and Zip Code

Name(s) of General Partner(s)

Document Number

Note: General partners MAY NOT be changed on this form; an amendment must be filed to change a general partner.

11.

I do hereby certify that the information supplied with this ling is voluntarily furnished and does not qualify for exemptions contained in Chapter 119, Florida Statutes. I release the Division of Corporations from any

liability of non-compliance with Chapter 119, F.S. in the event that the information supplied is deemed exempt from public access. I further certify that the information indicated on this annual report is true and accurate

and that my signature shall have the same legal e ects as if made under oath. I further certify that I am a General Partner of the limited partnership, receiver or trustee empowered to execute this report as required by

chapter 620, Florida Statutes. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S.

SIGNATURE

DATE

____________________________________________________________________________________________________________________________________________________________________

_________________________________________________________

Telephone Number

Typed or Printed Name of General Partner Signing Form

__________________________________________________________________________________________________________

_________________________________________________________