Illinois Uniform Partnership ActStatement of Foreign QualificationFORMUPA-1102October 2014Printed by authority of the State of Illinois. February 2018 226 1 226 UPA 13.9First NameMiddle InitialLast NameNumberStreetSuite #CityZIP SUBMIT IN DUPLICATEType or Print Clearly. Filing Fee: $500 Approved:Secretary of State Department of Business ServicesLimited Liability Division501 S. Second St., Rm. 351Springfield, IL 62756217-524-8008www.cyberdriveillinois.com Payment must be made by certifiedcheck, cashier220s check, money order,Illinois attorney220s check or IllinoisC.P.A.220s check. If a check is returned forany reason, this filing will be void. This space for use by Secretary of State.FILE #(The LLP must adopt an alternate name if the name in item 1 is not available for use in Illinois. The LLP agrees that it will conduct all business in Illinois using only the alternate name above.)IL(Name must end with 223Registered Limited Liability Partnership,224 223Limited Liability Partnership,224 223R.L.L.P.,224 223L.L.P.,224 or 223RLLP,224 223LLP224)Federal Employer Identification Number (F.E.I.N.): (Required to File)1. Partnership Name: 2. Alternate Name:3. State of Jurisdiction:4. Address of Chief Executive Office: Street Address (Must be a street address. P.O. Box alone is unacceptable.) City, State, ZIP5. If different from address in #4, street address of an office in this state, if any: 6. Registered Agent222s Name and Registered Office Address (must be an Illinois resident or company): Registered Agent: Registered Office: 7. Brief statement of the business in which the partnership engages: American LegalNet, Inc. www.FormsWorkFlow.com 8. Total number of partners:9. Names and mailing addresses of all partners:10. The partnership hereby applies for foreign qualification status as a Limited Liability Partnership.11. Registration application is effective on (check one): 002 a) the filing date 002 b) another date later than, but not more than 30 days subsequent to the filing date:12.This application is accompanied by a Certificate of Good Standing (within the last 30 days) from thedomicile state or country wherein the LLP is formed.13. The undersigned declares, under the penalty of perjury, under the laws of the State of Illinois, that the foregoing is true, correct and complete. Executed on the of , by at least two partners.If additional space is required, continue in the same format on a plain white 8.5x11224 sheet of paper.SignatureDayMonthYear Number, Street Address Name and Title (type or print) City, State, ZIP Signature Number, Street Address Name and Title (type or print) City, State, ZIPName, Street Address, City, State, ZIPName, Street Address, City, State, ZIPName, Street Address, City, State, ZIP Month, Day, YearUPA-1102 American LegalNet, Inc. www.FormsWorkFlow.com