Pursuant to section 486A.1001 of the Iowa Uniform Partnership Act, the undersigned partnership files its
Statement of Qualification as follows:
1. (a) The name of the partnership: ___________________________________________________________________
(b) The name of the 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. The street address of the partnership’s chief executive office:
____________________________________________________________________________________
street city state zip
3. The street address of an office in this state, if any. [If different than #2]:
____________________________________________________________________________________
street city state zip
4. Registered Agent and Registered Office**
(a) The name of the registered agent for service of process in Iowa:
____________________________________________________________________________________
(b) The address of the registered office:
____________________________________________________________________________________
**Required by Iowa Code section 486A.1211.
5. The partnership elects to be a limited liability partnership.
6. 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 ninetieth day after the date filed.
7. Signature by authorized partner(s): The statement shall be executed by one or more partners authorized to execute
this statement on behalf of the partnership.
____________________________________ /______________________________ /___________________
signature name capacity in which signing
____________________________________ /______________________________ /___________________
signature name capacity in which signing
____________________________________ /______________________________ /___________________
signature name capacity in which signing
NOTES:
1. The filing fee is $50.00. 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 QUALIFICATION
OF LIMITED LIABILITY
PARTNERSHIP
635_2002
Rev. 1/15
