Free Statement of Amendment - Illinois


File Size: 117.3 kB
Pages: 2
Date: September 26, 2008
File Format: PDF
State: Illinois
Category: Limited Liability Partnerships
Word Count: 409 Words, 3,745 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.cyberdriveillinois.com/publications/pdf_publications/upa1001h1102g.pdf

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FORM UPAAmendment (1001(h)/1102(g))
January 2008

Illinois Uniform Partnership Act
Statement of Amendment
Submit in duplicate. Please type or print clearly.

File #:

This space for use by Secretary of State.

Secretary of State Department of Business Services Limited Liability Division 501 S. Second St., Rm. 357 Springfield, IL 62756 217-785-8960 www.cyberdriveillinois.com

Payment may be made by check payable to Secretary of State. This space for use by Secretary of State. Date: Filing Fee: $25 Approved:

Federal Employer Identification Number (F.E.I.N.):____________________________________________________ 1. Partnership Name: ________________________________________________________________________ 2. State of Jurisdiction: ______________________________________________________________________________________________________ 3. The Statement of Qualification is amended as follows: (Check all applicable changes and specifiy them in item 4 below.) (For address changes -- P.O. Box alone is unacceptable.) a) Change of registered agent and/or registered agent's office (give new name/address, including county in item 4a) Must be an Illinois resident/company. b) Change in address of chief executive office (give new address in item 4b) c) Change in number of partners (give change of number of partners in item 4c) (Attach current list of partners.) (Total number of partners and number of Illinois partners.) d) Change in Limited Liability Partnership name (give name change in item 4d) (Certified copy of Amendment From Domicile State required.) e) Change in partner's name/address (give name/address change in item 4e) f) Other (give information in item 4f) 4. List all changes from item 3. a) ____________________________________________________________________________________ b) ____________________________________________________________________________________ c) ____________________________________________________________________________________ d) ____________________________________________________________________________________ e) ____________________________________________________________________________________ f) ____________________________________________________________________________________

Printed on recycled paper. Printed by authority of the State of Illinois. September 2008 -- 500 -- UPA 14.3

UPA-1001(h)/1102(g) 5. We declare, under the penalty of perjury, under the laws of the State of Illinois, that the foregoing is true, correct and complete. Executed on the _______________ of _________________ , ____________ by at least two partners.
Day Month Year

1. __________________________________________________
Signature

1.
2. 2.

________________________________________________
Street Address

1. 1.

__________________________________________________
Name (type or print)

________________________________________________
City, State, ZIP

__________________________________________________
Name if a Corporation or other Entity

2. __________________________________________________
Signature

2.
2. 2.

________________________________________________
Street Address

1. 1.

__________________________________________________
Name (type or print)

________________________________________________
City, State, ZIP

__________________________________________________
Name if a Corporation or other Entity

Signatures must be in BLACK INK on an original document. Carbon copy, photocopy or rubber stamp signatures may only be used on conformed copy. For additional space, continue in the same format on a plain white 8.5x11" sheet of paper.

Printed on recycled paper. Printed by authority of the State of Illinois. September 2008 -- 500 -- UPA 14.3