Uniform Partnership Act
Statement of Foreign Qualification
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
Type or Print Clearly.
Filing Fee: $500
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 351
Springfield, IL 62756
Payment must be made by certified
check, cashier’s check, money order,
Illinois attorneys 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.
(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.)
(Name must end with “Registered Limited Liability Partnership,” “Limited Liability Partnership,” “R.L.L.P.,” “L.L.P.,” or “RLLP,” “LLP”)
8. Total Number of Partners:
9. Names and Mailing Addresses of all Partners:
10. The partnership hereby applies for foreign qualification status as a Limited Liability Partnership.
11. Registration application is effective on (check one):
o a) the filing date
o b) another date later than but not more than 30 days subsequent to the filing date:
12. This application is accompanied by a Certificate of Good Standing (within the last 30 days) from the
domicile state or country wherein the LLP is formed.
13. The undersigned declares, under the penalty of perjury, under the laws of the State of Illinois, that the
foregoing is true, correct and complete.
Executed on the of , by at least two partners.
For additional space, continue in the same format on a plain white 8.5x11” sheet of paper.
Day Month Year
Number, Street Address
Name and Title (type or print) City, State, Zip
Signature Number, Street Address
Name and Title (type or print) City, State, Zip
Name, Street Address, City, State, Zip
Name, Street Address, City, State, Zip
Name, Street Address, City, State, Zip
Month, Day, Year