Delaware Division of Corporations 401 Federal Street ­ Suite 4 Dover, DE 19901 Ph: 302-739-3073 Fax: 302-739-3812 Statement of Qualification of Limited Liability Partnership Dear Sir or Madam: Enclosed is the Statement of Qualification of a Delaware Limited Liability Partnership to be filed in accordance with the Limited Liability Partnership Act of the State of Delaware. The fee to file the Certificate is $200.00 per partner. Please make your check payable to "Delaware Secretary of State". For the convenience of processing your order in a timely manner, please include a cover letter with your name, address and telephone/fax number to enable us to contact you if necessary. Please make sure you thoroughly complete all information requested on this form. It is important that the execution be legible, we request that you print or type your name under the signature line. Thank you for choosing Delaware as your corporate home. Should you require further assistance in this or any other matter, please don't hesitate to call us at (302) 739-3073. Sincerely, Department of State Division of Corporations encl. rev. 01/15 American LegalNet, Inc. www.FormsWorkFlow.com STATE OF DELAWARE STATEMENT OF QUALIFICATION 1. The name of the limited liability partnership is __________________________________________________________________ 2. The address of its registered office in the State of Delaware is ___________________________________________________________________ in the city of is______________________________________. The name of the registered agent is _____________________________________________________________ 3. The number of partners of the limited liability partnership is ________ 4. 5. The partnership elects to be a limited liability partnership. The effective date of this Statement of Qualification is ____________________. IN WITNESS WHEREOF, the undersigned have executed this Statement of Qualification this_________ day of_____________,_____________ A.D. ___________________________ Authorized Person or Partner Name: __________________________ Type or Print By: American LegalNet, Inc. www.FormsWorkFlow.com