PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF CORPORATIONS AND CHARITABLE ORGANIZATIONS Return document by mail to: Name Address City State Zip Code Return document by email to: _________________________________ Read all instructions prior to completing. Fee: $125 I qualify for a veteran/reservist-owned small business fee exemption (see instructions) In compliance with the requirements of 15 Pa.C.S. � 8201 (relating to statement of registration), the undersigned general partnership or limited partnership, desiring to register as domestic limited liability partnership or limited liability limited partnership, hereby certifies that: 1. The name of the domestic limited liability partnership or limited liability limited partnership is (designator is required, i.e., "company," "limited" or "limited liability partnership" or abbreviation): 2. Check and complete one of the following: The partnership is a general partnership and the address, including number and street, if any, of its principal place of business is: Number and street City State Zip County The partnership is a limited partnership and the (a) address of its current registered office in this Commonwealth or (b) name of its commercial registered office provider and the county of venue is: (Complete (a) or (b), not both) (a) Number and Street City State Zip County c/o: (b)Name of Commercial Registered Office Provider County 3. The general/limited (strike out inapplicable term) partnership registers under 15 Pa.C.S. Chapter 82 Subchapter A. 4. The registration has been authorized by at least a majority in interest of the partners. 5. Effective date of Statement of Registration (check, and if appropriate complete, one of the following): The Statement of Registration shall be effective upon filing in the Department of State. The Statement of Registration shall be effective on: _________________________ at __________________. Date (MM/DD/YYYY) Hour (if any) IN TESTIMONY WHEREOF, the undersigned general partner of the domestic limited liability partnership/limited liability limited partnership has executed this Statement of Registration this ______ day of _______________, ________. ________________________________________________________ Name ________________________________________________________ Signature ________________________________________________________ Title American LegalNet, Inc. www.FormsWorkFlow.com DSCB:15-8201A�Instructions Pennsylvania Department of State Bureau of Corporations and Charitable Organizations P.O. Box 8722 Harrisburg, PA 17105-8722 (717) 787-1057 Website: www.dos.pa.gov/corps General Information Typewritten is preferred. If handwritten, the form must be legible and completed in black or blue-black ink in order to permit reproduction. The nonrefundable filing fee for this form is $125. Checks should be made payable to the Department of State. Checks must contain a commercially pre-printed name and address. Filers requesting a veteran/reservist-owned small business fee exemption should attach proof of the veteran's or reservist's status to the Statement of Registration form when submitted. For more information on the fee exemption, see Fees and Payments. This form and all accompanying documents, including any necessary governmental approvals, shall be mailed to the address stated above. Who should file this form? The status of being a limited liability partnership is available for either general partnerships or limited partnerships. In the case of a limited partnership, the limited partners already enjoy limited liability, but registering will provide limited liability for the general partners. For a general partnership registering as a limited liability partnership, prior registration with the Department of State as a general partnership is not required. For a limited partnership registering as a limited liability limited partnership, the limited partnership must be an existing limited partnership filed with Department of State in order to use this form. Registration under 15 Pa.C.S. � 8201 does not change the basic form of organization of the registering partnership as either a general or limited partnership. Applicable Law For requirements on limited liability partnerships and limited liability limited partnerships, see 15 Pa.C.S. �� 8201-8244. Statutes are available on the Pennsylvania General Assembly website, www.legis.state.pa.us, by following the link for Statutes. Definitions A limited liability partnership is a domestic or foreign general partnership for which there is in effect: (1) a statement of registration under Chapter 82 (relating to limited liability partnerships and limited liability limited partnerships); or (2) a similar filing under the organic law of a foreign general partnership. A limited liability limited partnership is a domestic or foreign limited partnership for which there is in effect: (1) a statement of registration under Chapter 82; (2) a provision of its certificate of limited partnership electing to be subject to Chapter 82; or (3) a similar filing or provision under the organic law of a foreign partnership. Form Instructions Enter the name and mailing address to which any correspondence regarding this filing should be sent. This field must be completed for the Bureau to return the filing. If the filing is to be returned by email, an email address must be provided. An email will be sent to address provided, containing a link and instructions on how a copy of the filed document or correspondence may be downloaded. Any email or mailing addresses provided on this form will become part of the filed document and therefore public record. 1. Give the exact name of the limited liability partnership or limited liability limited partnership. The proper name of a domestic limited liability partnership must contain the term "company," "limited" or "limited liability partnership," or an abbreviation of one of those terms. This field is required. 2. Address. Under 15 Pa.C.S. � 135(c) (relating to addresses) an actual street or rural route box number must be used as an address, and the Department of State is required to refuse to receive or file any document that sets forth only a post office box address. For a general partnership, the address of the principal place of business should be set forth in the first part of Field 2. For a limited partnership, the registered office address should be set forth in the second part of Field 2. The registered office address may be a number an