$15.00 Filing Fee payable to Arkansas Secretary of State LP-AR Rev. ANNUAL REPORT FOR LIMITED PARTNERSHIP/ LIMITED LIABILITY LIMITED PARTNERSHIP (PLEASE TYPE OR PRINT CLEARLY IN INK) Report Due by May 1st estic eign 1.The name of the Limited Partnership or Limited Liability Limited Partnership is: 2.Designated Office Address Information: a. Street Address: b. Mailing Address if different: 3.a. Agent for service of process: Name: b.Street Address: c.Mailing Address: 4.If a Domestic Limited Partnership/ Limited Liability Limited Partnership: a.Street address of principal office b.Mailing address of principal office 5.If a Foreign Limited Partnership/ Limited Liability Limited Partnership: a.Jurisdiction under which entity was formed: b.Fictitious name or alternate name used in Arkansas: I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days. Executed this day of , . Printed Name and Title of Authorized Officer Signature and Title of Authorized Officer 001027021n024030n030007r013027r031n027035025016007031n031r$'#$t 003n026020031025022037004020031031022r006025013021 American LegalNet, Inc. www.FormsWorkFlow.com