STATEMENT OF QUALIFICATION
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
OF A DOMESTIC
LIMITED LIABILITY PARTNERSHIP
Please Type or Print Clearly in Ink
Please submit one Original and one Photocopy
FILING FEE: $125 payable to SECRETARY OF STATE
Telephone # ____________________
FAX # _______________________
1. The name of the limited liability partnership is __________________________________________________________
______________________________________________________________________________________________
The name shall contain the words “Registered Limited Liability Partnership”, or “Limited Liability Partnership”, or “R.L.L.P.” or “L.L.P.”, or “RLLP”, or
“LLP” as the last words of the name
2. The street address of the partnership’s chief executive office.
______________________________________________________________________________________________
Street Address City State ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional) City State ZIP+4
3. If the address listed in number 2 is not a South Dakota street address question number 4 must be completed.
4. The South Dakota Registered Agent name ____________________________________________________________
______________________________________________________________________________________________
Street Address or Rural Route Box Number in This State and City State ZIP+4
______________________________________________________________________________________________
Mailing Address in This State, if Different from Street Address City State ZIP+4
When listing a Commercial Registered Agent, please state their CRA #.
This number can be obtained from the Commercial Registered Agent.
_______________________________
5. The partnership elects to be a limited liability partnership.
6. The deferred effective date of the registration if it is not to be effective upon filing of the registration
____________________________________________
Clear Form
HELP
I declare under penalty of perjury that the contents of the above statement are accurate. Statement must be signed by at
least two partners.
Dated ____________________________ ______________________________________________
(Signature of a partner)
______________________________________________
(Printed Name)
Dated ____________________________ ______________________________________________
(Signature of a partner)
______________________________________________
(Printed Name)
LLPregistration April 2012