Free Kentucky Secretary of State - Kentucky

Kentucky Secretary of State TREY GRAYSON
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Division of Corporations BUSINESS FILINGS P.O. Box 718 Frankfort, KY 40602 (502) 564-2848 http://www.sos.ky.gov/

Statement of Qualification

KNL

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1.

Name of the partnership electing to be a limited liability partnership:
_________________________________________________________________________________________________________

2.

The street address of the chief executive office of the partnership (address must be a street address, not a post office box): _________________________________________________________________
_________________________________________________________________________________________________________

3.

The street address of a partnership office in Kentucky, if there is one:
_________________________________________________________________________________________________________ _________________________________________________________________________________________________________

4.

The street address of the Partnership's initial registered office and the name of its initial registered agent at that office: ___________________________________________________________________________________________
_________________________________________________________________________________________________________

5. 6.

Please check if the above named partnership elects to be a limited liability partnership: The partnership previously filed a Statement of Authority with the Secretary of State on:
___________________________________________ (Day/Month/Year)

We declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct. Executed by two partners: ___________________________________________ (Day/Month/Year)
_____________________________________________________ _____________________________________________________

(Signature)
_____________________________________________________

(Signature)
_____________________________________________________

(Type or Print Name)

(Type or Print Name)

I, _________________________________________________________, consent to serve as the registered agent on behalf of the partnership.
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(Registered Agent Signature)
_______________________________________________________

(Type or Print Name)

Instructions: KNL (08/2006) Submit this form with one (1) exact or conformed copy. The filing fee is $40.00. Please make check payable to the "Kentucky State Treasurer." All information must be completed or this document will not be accepted for filing. The name of the limited liability partnership must end with the words "R.L.L.P", "L.L.P.", "RLLP", "LLP", "Registered Limited Liability Partnership" or "Limited Liability Partnership."