$300.00 Filing Fee payable to Arkansas Secretary of State Rev. STATEMENT OF QUALIFICATION OF FOREIGN LIMITED LIABILITY PARTNERSHIP ()(PLEASE TYPE OR PRINT CLEARLY IN INK) 001027021n024030n030007r013027r031n027035025016007031n031r$'#$t 003n026020031025022037004020031031022r006025013021 American LegalNet, Inc. www.FormsWorkFlow.com Rev. Annual Report Contact Information LIMITED LIABILITY PARTNERSHIP PLEASE TYPE OR PRINT CLEARLY IN INK JURISDICTION (SELECT ONE) In order for this entity to receive its annual reporting form, please complete and file with the Office of the Secretary of State at the time of filing. Entity name as used in Arkansas Contact Person Street Address or Post Office Box Number City, State & Zip Telephone Number E-mail Address NOTE: Annual Reports will be due on or before April 1st the year following filing or qualification in this state. 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 $100.00 and/or imprisonment up to 30 days. Executed this day of , . Signature Authorized Officer (Type or Print) 001027021n024030n030007r013027r031n027035025016007031n031r$'#$t 003n026020031025022037004020031031022r006025013021 American LegalNet, Inc. www.FormsWorkFlow.com