THE STATE BAR OF CALIFORNIA LIMITED LIABILITY PARTNERSHIPS 180 Howard Street · San Francisco, CA 94105-1617 (888) 800-3400 · llp@calbar.ca.gov Application for Issuance of a Certificate of Registration as a Limited Liability Partnership (LLP) 1) LLP INFORMATION Name of Limited Liability Partnership (LLP): (The LLP name must comply with Rule 1-400 of the California Rules of Professional Conduct) Address 1: Address 2: City: Contact Name: E-mail: The following partners are authorized to act on behalf of the LLP: Partner Name: Partner Name: Partner Name: 2) ATTACHMENTS Complete and Attach the following: Attachment 1: LLP List of Partners. Attachment 2: LLP List of Non-Partners. Attachment 3: Declaration of Compliance with Rule 1-400, Rule of Professional Conduct of the State Bar of California. Attachment 4: Declaration of Compliance with California Corporations Code Section 16956 (a)(2). Secretary of State Certification: Attach an original certified copy of the Secretary of State's Registered Limited Liability Partnership Registration (LLP-1) including Secretary of State date-stamp. The form is available from the Office of the Secretary of State. Payment: A $50 per partner (minimum of $100 up to a maximum of $2500) non-refundable fee must accompany this Application. Make checks payable to: The State Bar of California. State: Zip: + Phone: Attorney License or Member #: Attorney License or Member #: Attorney License or Member #: 3) DECLARATION I am (Name of partner authorized to act on behalf of the LLP) and I am authorized to act on behalf and as such make this declaration (Full Name of Limited Liability Partnership) of for and on behalf of said partnership. I have read the foregoing and all attachments thereto and know the contents thereof and the same are true of my own knowledge. I declare under penalty of perjury under the laws of the State of California that the foregoing application and all attachments are true and correct and that the applicant is an existing Limited Liability Partnership and that its affairs will be conducted in compliance with the State Bar Act, and the applicable provisions of the Corporations Code, The Rules of Professional Conduct of the State Bar, the Limited Liability Partnership Rules of the State Bar and such other laws, rules and regulations as may be applicable. Executed On: Signature: Print Name: 4) SUBMISSION INFORMATION Submit completed application with all attachments and payment to: The State Bar of California Limited Liability Partnerships Department #05017 PO Box 39000 San Francisco, CA 94139-5017 American LegalNet, Inc. www.FormsWorkFlow.com LLPApp-0211 Instructions for Application for Issuance of Certificate of Registration as a LLP A $50 per partner (minimum of $100, up to a maximum of $2,500) non-refundable fee must accompany this application. SPECIFIC INSTRUCTIONS Fill in the complete name of the limited liability partnership (LLP). This name must be the same name set forth on the Secretary of State's Registered Limited Liability Partnership Registration (LLP-1). Fill in the address of record for the LLP. To change the address of record of the LLP or to file any special reports other than the Annual Report, notification must be forwarded in writing to The State Bar of California, MSC, 180 Howard Street, San Francisco, CA 94105. Note that change of an individual's bar member's official State Bar address does not change the address of record for an LLP. Fill in the name the telephone number, and the e-mail address of the person the State Bar will contact should issues arise. Fill in the name of the partner or partners authorized to act on behalf of the LLP for State Bar purposes. If the authorized partner is a law corporation, set forth the complete name of the corporation. A shareholder of the law corporation may sign on behalf of the corporation wherever the signature of the authorized partner is required. Please specify that you are signing on behalf of the corporation. Complete and submit the following: A. Attachment 1. List the names of all attorney and/or law corporation partners in the LLP. Attorney License/Member Number need only be provided for attorneys licensed to practice in California. For Jurisdiction(s) in which Admitted to Practice, list only states and/or countries. If your LLP includes a partner or partners who are licensed only in a non-U.S. jurisdiction, see State Bar LLP Rule 3.172(A)(3). If a partner is licensed in more than one jurisdiction, list the primary jurisdiction first. (A partner licensed to practice law in California will be entered as a California partner unless you specify otherwise.) You may attach additional pages if necessary. NOTE: If you list the name of a law corporation partner on Attachment 1, do not list the shareholder(s) as an individual attorney partner(s), unless the shareholder(s) and the law corporation are separate partners in the LLP. B. Attachment 2. List the names of all non-partners, including employees and all other persons and/or law corporations practicing in partnership, association and/or "of counsel" with the LLP in a continuous relationship. "Continuous relationship" means co-counsel, contract attorneys, any person sharing office space, and/or any person practicing "of counsel" to the LLP. You may attach additional pages if necessary. C. Attachment 3. See State Bar LLP Rule 3.171(C) and California Rule of Professional Conduct 1-400. D. Attachment 4. See Corporations Code Section 16956 (a)(2), Business and Professions Code 6174.5, and State Bar Limited Liability Rule 3.172 (A)(2). E. Secretary of State Certification. Attach an original certified copy (including the cover with the date stamp) of the Secretary of State's Registered Limited Liability Partnership Registration (LLP-1). The form is available from the office of The Secretary of State. NOTE: The application will not be processed or certified until all attachments are received in our office. The declarations must be signed by a partner authorized to act on behalf of the LLP. If the authorized partner is a law corporation, set forth the complete name of the corporation. A shareholder of the law corporation may sign on behalf of the corporation. Please specify that you are signing on behalf of the corporation. The application is not complete unless it has an original signature. No copies of signature, please. Without the original signed declaration by a partner authorized to act on behalf of the LLP, certification cannot b