PAUL D. PATE Secretary of State State of Iowa STATEMENT OF QUALIFICATION OF LIMITED LIABILITY PARTNERSHIP Pursuant to section 486A.1001 of the Iowa Uniform Partnership Act, the undersigned partnership files its Statement of Qualification as follows: 1. (a) The name of the partnership: ___________________________________________________________________ *Note: The name must end with "Registered Limited Liability Partnership", "Limited Liability Partnership", or the abbreviation "R.L.L.P.", "L.L.P.", "RLLP", or "LLP". (b) The name of the limited liability partnership*: _______________________________________________________ 2. The street address of the partnership's chief executive office: ____________________________________________________________________________________ street city state zip 3. The street address of an office in this state, if any. [If different than #2]: ____________________________________________________________________________________ street city state zip 4. Registered Agent and Registered Office** (a) The name of the registered agent for service of process in Iowa: ____________________________________________________________________________________ (b) The address of the registered office: ____________________________________________________________________________________ **Required by Iowa Code section 486A.1211. 5. The partnership elects to be a limited liability partnership. 6. The deferred effective date*** (and time), if any, is ___________________, _______, _________; (__________)(______) month ***A delayed effective date shall not be later than the ninetieth day after the date filed. day year time am/pm 7. Signature by authorized partner(s): The statement shall be executed by one or more partners authorized to execute this statement on behalf of the partnership. ____________________________________ / ______________________________ / ___________________ signature name capacity in which signing ____________________________________ / ______________________________ / ___________________ signature name capacity in which signing ____________________________________ / ______________________________ / ___________________ signature name capacity in which signing NOTES: 1. The filing fee is $50.00. Make checks payable to SECRETARY OF STATE 2. The information you provide will be open to public inspection under Iowa Code chapter 22.11. SECRETARY OF STATE Business Services Division Lucas Building, 1st Floor Des Moines, IA 50319 Phone: (515) 281-5204 FAX: (515) 242-5953 Website: sos.iowa.gov American LegalNet, Inc. www.FormsWorkFlow.com 635_2002 Rev. 1/15