Statement Of Foreign Qualification

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UPA-1102
Illinois
FILE #
FORM
Uniform Partnership Act
This space for use by Secretary of State.
October 2014
Statement of Foreign Qualification
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 351
SUBMIT IN DUPLICATE
Springfield, IL 62756
Type or Print Clearly.
217-524-8008
Filing Fee: $500
Payment must be made by certified
check, cashier’s check, money order,
Approved:
Illinois attorney’s check or Illinois
C.P.A.’s check. If a check is returned for
any reason, this filing will be void.
Federal Employer Identification Number (F.E.I.N.) ________________________________________________________________
(Required to File)
1. Partnership Name: ________________________________________________________________________
(Name must end with “Registered Limited Liability Partnership,” “Limited Liability Partnership,” “R.L. L . P.,” “L.L.P.,” or “RLLP,” “LLP”)
2. Assumed Name:__________________________________________________________________________
(The LLP must adopt an assumed name if the name in item 1 is not available for use in Illinois. The LLP agrees that it will conduct all business
in Illinois using only the assumed name above.)
3. State of Jurisdiction: ______________________________________________________________________
4. Address of Chief Executive Office:
______________________________________________________________________________________
Street Address (Must be a street address. P.O. Box alone is unacceptable.)
______________________________________________________________________________________
City, State, Zip
5. If different from Address in #4, Street Address of an Office in this State, if any:
______________________________________________________________________________________
______________________________________________________________________________________
6. Registered Agent’s Name and Registered Office Address: (must be an Illinois resident or company)
Registered Agent: ________________________________________________________________________
First Name
Middle Initial
Last Name
Registered Office: ________________________________________________________________________
IL
Number
Street
Suite #
________________________________________________________________________
City
Zip
7. Brief Statement of the Business in which the Partnership Engages: ______________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Printed by authority of the State of Illinois. November 2014 – 1 – UPA 13.8

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