Pursuant to section 486A.1102 of the Iowa Uniform Partnership Act, the undersigned foreign limited liability partnership files its
Statement of Foreign Qualification as follows:
1. The Name of the foreign limited liability partnership*: _____________________________________________________ .
*Note: The name must end with “Registered Limited Liability Partnership”, “Limited Liability Partnership”, or the abbreviation “R.L.L.P.”, “L.L.P.”, “RLLP”, or “LLP”.
2. (a) The street address of the partnership’s chief executive office:
_____________________________________________________________________________________ .
street city state zip
(b) The street address of an office in this state, if any. [If different than #2]:
_____________________________________________________________________________________ .
street city state zip
[If there is no office of the partnership in Iowa, complete #3]
3. Registered Agent and Registered Office
(a) The
name of the registered agent for service of process in Iowa:**
_____________________________________________________________________________________ .
**Agent must be an individual who is a resident of Iowa or other person authorized to do business in Iowa.
(b) The street address of the agent for service of process:
_____________________________________________________________________________________ .
4. The deferred effective date***(and time) if any, is _______________________, ______, _________; (__________)(______).
month day year time am/pm
***A delayed effective date shall not be later than the nintieth day after the date filed.
5. Signature by authorized partner(s): The statement shall be executed by two or more partners authorized under chapter
486A, the partnership agreement, or other law. If the partnership is in the hands of a receiver,trustee, or other court appointed
fiduciary, the statement must be signed by such receiver, trustee, or fiduciary.
__________________________________ / ____________________________ / ______________________
signature name capacity in which signing
__________________________________ / ____________________________ / ______________________
signature name capacity in which signing
__________________________________ / ____________________________ / ______________________
signature name capacity in which signing
NOTES:
1. The filing fee is $100.00. Make checks payable to SECRETARY OF STATE
2. The information you provide will be open to public inspection under Iowa Code chapter 22.11.
SECRETARY OF STATE
Business Services Division
Lucas Building, 1
st
Floor
Des Moines, IA 50319
Phone: (515) 281-5204
FAX: (515) 242-5953
Website: sos.iowa.gov
PAUL D. PATE
Secretary of State
State of Iowa
STATEMENT OF
FOREIGN QUALIFICATION OF
FOREIGN LIMITED LIABILITY
PARTNERSHIP
635_2003
Rev. 1/15