Contact Information KANSAS SECRETARY OF STATE Kansas Secretary of State Ron Thornburgh Memorial Hall, 1st Floor 120 S.W. 10th Avenue Topeka, KS 66612-1594 (785) 296-4564 kssos@kssos.org www.kssos.org Limited Liability Partnership Statement of Qualification QLLP 51 All information must be completed or this document will not be accepted for filing. 1. Name of the limited liability partnership: _________________________________________________________ 2. Partnership’s principal address: Address must be a street address. A post office box is unacceptable. Do not write in this space _________________________________________________________ Street address _________________________ ______________ _______________ City State Zip 3. If different from above, the address of any partnership office in Kansas: _________________________________________ _____________________________ Street address City __________________ _____________ State Zip 4. If there is no office in Kansas, give the name and street address of the partnership’s agent for service of process. The agent must be an individual resident or person authorized to do business in this state. ___________________________________________________________________________________________________________ Name _________________________________________ _____________________________ Street address City __________________ _____________ State Zip 5. The future effective date of qualification, if not effective upon filing: _________________________________________________ 6. The above-named partnership elects to be (check one): a foreign limited liability partnership from _________________ or Home state a Kansas limited liability partnership We declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct. Executed on the ________ of ___________ , _____________ by two partners. Day Signature Month Year Signature Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com LLP Mailing Information Where would you like the Secretary of State’s office to send official mail? If no address is given, the mail will be sent to the partnership’s principal office given in paragraph two. Street address City State Zip Country The mail should be addressed to the following named individual: Instructions 1. The name of the limited liability partnership must end with the words “registered limited liability partnership,” “limited liability partnership,” “R.L.L.P.,” “L.L.P.,” “RLLP” or “LLP.” 2. Submit this form with the $165 filing fee. Notice: There is a $25 service fee for all returned checks. Rev. 12/07/04 jls Rev. 8/11/03 jb K.S.A. 56a-1001, 1102 Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com