Illinois
Uniform Partnership Act
Statement of Foreign Qualification
FORM UPA-1102
October 2014
Federal Employer Identification Number (F.E.I.N.) ________________________________________________________________
(Required to File)
1. Partnership Name:________________________________________________________________________
2. Assumed Name:__________________________________________________________________________
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: ________________________________________________________________________
Registered Office: ________________________________________________________________________
________________________________________________________________________
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
First Name Middle Initial Last Name
Number Street Suite #
City Zip
SUBMIT IN DUPLICATE
Type or Print Clearly.
Filing Fee: $500
Approved:
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 351
Springfield, IL 62756
217-524-8008
www.cyberdriveillinois.com
Payment must be made by certified
check, cashier’s check, money order,
Illinois attorney’s check or Illinois
C.P.A.’s check. If a check is returned for
any reason, this filing will be void.
This space for use by Secretary of State.
FILE #
(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.)
IL
(Name must end with “Registered Limited Liability Partnership,” “Limited Liability Partnership,” “R.L.L.P.,” “L.L.P.,” or “RLLP,” “LLP”)