ALP 53-14 CONTACT: KANSAS SECRETARY OF STATE Limited Liability Partnership Amendment to Statement of Qualification Kansas Office of the Secretary of State Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 i (785) 296-4564 kssos@sos.ks.gov www.sos.ks.gov Above space is for office use only. All information must be completed or this document will not be accepted for filing. Please read instructions before completing. INSTRUCTIONS: 1. Business entity ID number: This is not the Federal Employer ID Number (FEIN) _______________________________________ 2. Name of the partnership: Name must match the name on record with the Secretary of State ________________________________________________________________________________________ 3. The statement of qualification is amended as follows: 4. Future effective date: Upon filing Future effective date ______________________________ Month Day Year 5. I declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct and that I have remitted the required fee. ________________________________________________________ Signature of partner ________________________________________________________ Name of signer (printed or typed) _______________________________________________________ _ Date (month, day, year) i Instructions: 1. Submit this form with the $35 filing fee. 2. The persons filing the amendment must promptly send a copy to every nonfiling partner. 3. A certified copy of the amendment filed in another state may be filed instead of this form. STAY UP-TO-DATE ON YOUR ORGANIZATION’S STATUS, ANNUAL REPORT DUE DATE AND CONTACT ADDRESSES BY GOING TO WWW.SOS.KS.GOV. UNDER QUICK LINKS, SELECT SEARCH BUSINESS ENTITY INFORMATION. There is a $25 service fee for all checks returned by your financial institution. All information must be completed or this document will not be accepted for filing. NOTICE: Rev. 12/27/10 jdr Page 1 of 1 K.S.A. 56a-105 American LegalNet, Inc. www.FormsWorkFlow.com