Statement Of Election To Be A Reporting Entity Form - Colorado Secretary Of State
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1
2Form must be filed electronically.
Paper forms are not accepted.
This copy is a sample and cannot be submitted for filing.
Statement of Election to Be a Reporting Entity
filed pursuant to § 7-90-501 (7.5) of the Colorado Revised Statutes (C.R.S.)
1. The entity ID number and the entity name are
Entity ID number
__________________________
(Colorado Secretary of State ID number)
Entity name
______________________________________________________.
2. The principal office address of the limited partnership’s principal office is
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ ______________
(Province – if applicable)
(Country)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________ ____ ____________________
(City)
(State)
(ZIP/Postal Code)
_______________________ ______________.
(Province – if applicable)
(Country)
3. The registered agent name and registered agent address of the limited partnership’s registered agent are
Name
(if an individual)
____________________ ______________ ______________ _____
(Last)
(First)
(Middle)
(Suffix)
OR
(if an entity)
______________________________________________________
(Caution: Do not provide both an individual and an entity name.)
Street address
______________________________________________________
(Street number and name)
______________________________________________________
__________________________
CO
____________________
(City)
(State)
(ZIP Code)
Mailing address
______________________________________________________
(leave blank if same as street address)
(Street number and name or Post Office Box information)
______________________________________________________
__________________________
CO
____________________.
(City)
(State)
(ZIP Code)
(The following statement is adopted by marking the box.)
The person appointed as registered agent has consented to being so appointed.
ELECT_DLP
Page 1 of 2
Rev. 12/08/2008
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