F0410 - Page 1 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 *0410-1-2* (601) 359-1333 Application for Registration of Foreign Limited Liability Partnership The undersigned Limited Liability Partnership applies for registration to transact business as follows: 1. Name of Limited Liability Partnership 2. Organized under laws of the jurisdiction or state of Date Organized 3. The future effective date is (Complete if applicable) 4. Address of the office required to be maintained in the state or county under the laws in the state in which it was organized (Complete if applicable) Address City, State, ZIP5, ZIP4 - 5. Address of the principal office in the state or county under the laws in the state in which it was organized (Complete if office address is not required) Address City, State, ZIP5, ZIP4 - 6. If the Limited Liability Partnership is to have a specific date of dissolution, the latest date upon which this Limited Liability Partnership is to dissolve 7. Name, Street and Mailing Address of the Registered Agent is Name Physical Address Rev. 09/06 American LegalNet, Inc. www.FormsWorkflow.com F0410 - Page 2 of 2 OFFICE OF THE MISSISSIPPI SECRETARY OF STATE P.O. BOX 136, JACKSON, MS 39205-0136 *0410-2-2* (601) 359-1333 Application for Registration of Foreign Limited Liability Partnership P.O. Box City, State, ZIP5, ZIP4 MS - 8. Telephone No. of the Registered Agent 9. The Secretary of State is appointed the Registered Agent for services of process if the Registered Agent’s authority has been revoked or if the Registered Agent cannot be found or served with the exercise of responsible diligence. 10. This partnership is a Limited Liability Partnership. 11. Other matters the Foreign Limited Liability Partnership determines to include 12. Name elected to use in Mississippi Rev. 09/06 Signature (Please keep writing within blocks) Printed Name By: Title American LegalNet, Inc. www.FormsWorkflow.com