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/

Amendment to Statement of Qualification

SQA

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1. The name of the limited liability partnership (name must match the name on record with the Secretary of State):
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2.

The statement of qualification is amended as follows:
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3.

The future effective date of the amendment, if not effective upon filing: (Day/Month/Year)

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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:
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(Day/Month/Year)
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(Signature)
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(Signature)
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(Type or Print Name)

(Type or Print Name)

Instructions: 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.

SQA (07/2006)