MISSISSIPPI SECRETARY OF STATE POST OFFICE BOX 136 JACKSON, MISSISSIPPI 39205-0136 CUSTOMER SERVICE 601-359-1633 www.sos.state.ms.us
Amendment to Statement of Qualification of Domestic Limited Liability Partnership
Filing Fee $50.00. Type or print legibly in blue or black ink. Please do not highlight or write above this line.
1. Name of partnership currently on file:
2. Statement of a Qualification date:
Business ID Number:
3. Name as set forth in Statement of Qualification, if different from current name:
4. The statement has been amended as follows (provide section number, if available): *
5. Declaration and Signature: I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF MISSISSIPPI THAT THE FOREGOING IS TRUE AND CORRECT OF MY OWN KNOWLEDGE.
____________________________________________ Signature of Partner (as authorized)
Date
IMPORTANT: Failure to include any of the above information and submit the filing fee may cause this filing to be rejected. * If adding new partners, provide names and mailing addresses. Submit completed form along with the filing fee of $50.00 to Mississippi Secretary of State, Business Services Division, Post Office Box 136, Jackson, Mississippi 39205-0136.
Effective Date: January 1, 2007
SOS PARTNERSHIP FORM FS 0711