DO NOT STAPLE FORM UPA-1003-(F) January 2008 Secretary of State Department of Business Services Limited Liability Division 501 S. Second St., Rm. 357 Springfield, IL 62756 217-785-8960 www.cyberdriveillinois.com Illinois Uniform Partnership Act File #: Renewal Statement of Foreign Limited Liability Partnership Payment may be made by check payable to Secretary of State. This space for use by Secretary of State. This space for use by Secretary of State. Date: Filing Fee: $300 Approved: This renewal application is effective for one year, and will expire if not renewed within 60 days prior to the anniversary date of the original registration with the Secretary of State. DO NOT MAKE CHANGES ON THIS FORM. IF CHANGES ARE NECESSARY, AMENDMENT FORM UPA-1001(h)/1102(g) AND THE $25 FEE IS REQUIRED. 1. Registered Limited Liability Partnership Name: __________________________________________________ 2. Federal Employer Identification Number (FEIN): ________________________________________________ 3. State of Jurisdiction: ______________________________________________________________________ 4. Effective Date of Initial Registration in Illinois: ________________________________________________ 5. Address of Chief Executive Office (P.O. Box alone and c/o are unacceptable.): __________________________ ______________________________________________________________________________________ 6. Illinois Registered Agent: __________________________________________________________________ Illinois Registered Office (P.O. Box alone and c/o are unacceptable.): ________________________________ ______________________________________________________________________________________ 7. Total Number of Partners currently (minimum of 2): ______________________________________________ 8. Brief statement of the business in which the partnership engages: __________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ♻ Printed on recycled paper. Printed by authority of the State of Illinois. September 2008 – 500 – RLLP 3.7 American LegalNet, Inc. www.FormsWorkflow.com UPA-1003-F 9. The partnership hereby applies for continual status as a foreign Limited Liability Partnership. 10. This renewal statement is accompanied by a Certificate of Good Standing from the proper officer of the state or country wherein the LLP is formed. 11. The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this renewal application is to the best of my knowledge and belief, true, correct and complete. Dated 20 Month, Day Year 1. __________________________________________________ 1. Signature 1. __________________________________________________ Street Address 2. Name (type or print) 1. __________________________________________________ 2. __________________________________________________ 2. __________________________________________________ 2. 2. __________________________________________________ 3. __________________________________________________ Name if a Corporation or other Entity ________________________________________________ Street Address 2. Name (type or print) 1. ________________________________________________ State, ZIP Signature 1. ________________________________________________ City, Town Name if a Corporation or other Entity 3. __________________________________________________ ________________________________________________ Street Address Name (type or print) 1. ________________________________________________ State, ZIP Signature 1. ________________________________________________ City, Town Name if a Corporation or other Entity 2. __________________________________________________ ________________________________________________ ________________________________________________ City, Town 2. ________________________________________________ State, ZIP ♻ Printed on recycled paper. Printed by authority of the State of Illinois. September 2008 – 500 – RLLP 3.7 American LegalNet, Inc. www.FormsWorkflow.com