Statement Of Amendment Form. This is a Illinois form and can be use in Limited Liability Partnership Secretary Of State.
Tags: Statement Of Amendment, UPA-1001(H)-1102(G), Illinois Secretary Of State, Limited Liability Partnership
DO NOT STAPLE FORM UPAAmendment (1001(h)/1102(g)) Illinois Uniform Partnership Act File #: Statement of Amendment January 2008 Submit in duplicate. Please type or print clearly. 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 This space for use by Secretary of State. Payment may be made by check payable to Secretary of State. This space for use by Secretary of State. Date: Filing Fee: $25 Approved: Federal Employer Identification Number (F.E.I.N.):____________________________________________________ 1. Partnership Name: ________________________________________________________________________ 2. State of Jurisdiction: ______________________________________________________________________________________________________ 3. The Statement of Qualification is amended as follows: (Check all applicable changes and specifiy them in item 4 below.) (For address changes — P.O. Box alone is unacceptable.) ❏ a) Change of registered agent and/or registered agent’s office (give new name/address, including county in item 4a) Must be an Illinois resident/company. ❏ b) Change in address of chief executive office (give new address in item 4b) ❏ c) Change in number of partners (give change of number of partners in item 4c) (Attach current list of partners.) (Total number of partners and number of Illinois partners.) ❏ d) Change in Limited Liability Partnership name (give name change in item 4d) (Certified copy of Amendment From Domicile State required.) ❏ e) Change in partner’s name/address (give name/address change in item 4e) ❏ f) Other (give information in item 4f) 4. List all changes from item 3. a) ____________________________________________________________________________________ b) ____________________________________________________________________________________ c) ____________________________________________________________________________________ d) ____________________________________________________________________________________ e) ____________________________________________________________________________________ f) ____________________________________________________________________________________ ♻ Printed on recycled paper. Printed by authority of the State of Illinois. September 2008 — 500 — UPA 14.3 American LegalNet, Inc. www.FormsWorkflow.com UPA-1001(h)/1102(g) 5. We declare, 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. Day Month 1. __________________________________________________ Year 1. Signature 1. __________________________________________________ Street Address 2. Name (type or print) 1. __________________________________________________ ________________________________________________ ________________________________________________ City, State, ZIP 2. Name if a Corporation or other Entity 2. __________________________________________________ 2. Signature 1. __________________________________________________ Street Address 2. Name (type or print) 1. __________________________________________________ ________________________________________________ ________________________________________________ City, State, ZIP 2. Name if a Corporation or other Entity Signatures must be in BLACK INK on an original document. Carbon copy, photocopy or rubber stamp signatures may only be used on conformed copy. For additional space, continue in the same format on a plain white 8.5x11” sheet of paper. ♻ Printed on recycled paper. Printed by authority of the State of Illinois. September 2008 — 500 — UPA 14.3 American LegalNet, Inc. www.FormsWorkflow.com