Statement of Qualification of
Limited Liability Partnership
Delaware Division of Corporations
401 Federal Street Suite 4 Dover,
DE 19901 Ph: 302-739-3073 Fax:
302-739-3812
Dear Sir or Madam:
Enclosed is the Statement of Qualification of a Delaware Limited Liability Partnership to be
filed in accordance with the Limited Liability Partnership Act of the State of Delaware. The
fee to file the Certificate is $200.00 per partner. Please make your check payable to
“Delaware Secretary of State”.
For the convenience of processing your order in a timely manner, please include a cover letter
with your name, address and telephone/fax number to enable us to contact you if necessary.
Please make sure you thoroughly complete all information requested on this form. It is
important that the execution be legible, we request that you print or type your name under the
signature line.
Thank you for choosing Delaware as your corporate home. Should you require further
assistance in this or any other matter, please don’t hesitate to call us at (302) 739-3073.
Sincerely,
Department of State
Division of Corporations
STATE OF DELAWARE
STATEMENT OF QUALIFICATION
1. The name of the limited liability partnership is
__________________________________________________________________
2. The address of its registered office in the State of Delaware is
___________________________________________________________________
in the city of __________________, Zip Code_________________. The name of
the registered agent is ______________________________________________.
3. The number of partners of the limited liability partnership is ________
4. The partnership elects to be a limited liability partnership.
5. The effective date of this Statement of Qualification is ____________________.
IN WITNESS WHEREOF, the undersigned have executed this Statement of
Qualification this_________ day of_____________, _____________ A.D.
By: ___________________________
Authorized Person or Partner
Name: __________________________
Type or Print