FOREIGN LIMITED LIABILITY PARTNERSHIP FILING FEE: $ 15.00 DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS STATE OF HAWAII BUSINESS REGISTRATION DIVISION H 335 Merchant Street Mailing Address: Annual Filing, P.O. Box 40, Honolulu, HI. 96810 FOREIGN LIMITED LIABILITY PARTNERSHIP ANNUAL REPORT AS OF: NAME AND MAILING ADDRESS OF PARTNERSHIP: (If the above mailing address has changed, line out and print change to the right.) 1. Partnership was formed under the laws of: 2. The address of the Principal Office is: (If any change, line out and print change to the right ) 3. Nature of activities in Hawaii: (Optional) (If any change, line out and print correction below.) 4. The name of the registered agent and the registered agent's street address of the place of business in Hawaii of the person to which service of process and other notice and documents being served on or sent to the entity represented by it may be delivered to. (If any change, line out and print change on the right. See reverse side for instructions.). 5. None of the partners is either a minor or an incompetent person. 6. Below are the name and address of each partner. (If there are any changes to the list, line out deleted names or insert new names and addresses.) NAME IN FULL ADDRESS ( INCLUDE CITY, STATE & ZIP CODE) CERTIFICATION I certify under the penalties of Section 425- 172, Hawaii Revised Statutes, that I have read the above and the information is true and correct, and I am authorized to sign this report. DATE: FILE NO. Rev. 10/2013 Signature of authorized partner Print Name L36 L39 BSA File this Original (SEE REVERSE SIDE FOR INSTRUCTIONS) American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS (If any questions, call (808) 586-2727) The annual report must be typewritten or printed in Black Ink, and must be legible. The report must be signed in black ink and certified by an authorized partner. The filing fee of $ 15.00 must be submitted with the report. Make check payable to the DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS. Filing fee is not refundable. Your cancelled check is your receipt. There is a $ 25.00 charge for all dishonored checks. Failure to file an annual report for any year within the prescribed time will make each partner liable severally to the state in the amount of $25.00 for each and every month while default shall continue. The Director of Commerce and Consumer Affairs may revoke the statement of foreign qualification of a foreign limited liability partnership for failure to file an annual report for a period of two years. 1. List the State or Country where the partnership was formed. 2. State the address of the partnership's principal office. 3. (Optional) State a brief description of the nature of business. If inactive for the period, state "INACTIVE". (Annual report must be filed for the period, even though the partnership was inactive.) 4. State the name of the registered agent and the complete street address (including number, street, city, state, and zip code) in Hawaii. The agent must be an individual resident of Hawaii, a domestic entity, or a foreign entity authorized to transact business or conduct affairs in the State of Hawaii. (The Director of Commerce and Consumer Affairs may cancel the registration for failure to maintain a registered agent and registered office.) 5. The statement that none of the partners is either a minor or incompetent person is required. 6. State the names and business addresses of all partners. Due Date: Effective January 1, 2003, for a domestic or foreign limited liability partnership whose date of registration in this State falls between: (1) January 1 and March 31, an annual reportt shall be filed on or before March 31 of each year and shall reflect the state of the partnership's affairs as of January 1 of the year when filed; (2) April 1 and June 30, an annual reportt shall be filed on or before June 30 of each year and shall reflect the state of the partnership's affairs as of April 1 of the year when filed; (3) July 1 and September 30, an annual reportt shall be filed on or before September 30 of each year and shall reflect the state of the partnership's affairs as of July 1 of the year when filed; and (4) October 1 and December 31, an annual reportt shall be filed on or before December 31 of each year and shall reflect the state of the partnership's affairs as of October 1 of the year when filed. New Partnerships An annual report is not required to be filed in the year the foreign limited liability partnership was registered. This material can be made available for individuals with special needs. Please call the Division Secretary, Business Registration Division, DCCA, at 586-2744, to submit your request. All Business Registration filings are open to public inspection. (Section 92F-11, HRS) Mail the completed report with fee to: Annual filing - BREG P.O. Box 40 Honolulu, HI 96810 DID YOU REMEMBER TO SIGN YOUR REPORT AND CHECK? Renew online at www.ehawaii.gov/annuals American LegalNet, Inc. www.FormsWorkFlow.com