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                                                                                                                            DO NOT WRITE IN THIS  PACES           
                              State of Arizona – Office of the Secretary of State
                              Annual Report Pursuant to A.R.S. § 29-1103 
                              All Partnerships (Liability in Title) 
                              SEND BY MAIL TO: 
                                   Secretary of State Adrian Fontes, Atten: Limited Partnerships 
                                   1700 W. Washington Street, FL. 7, Phoenix, AZ 85007-2808 
                              OR return this application in person: 
                              PHOENIX - State Capitol Executive Tower,        TUCSON - Arizona State Complex,
                              1700 W. Washington Street, 2nd Fl., Ste. 220     400 W. Congress, 1st Fl., Suite 141 
                              Office     Hours: Monday through Friday, 8 a.m. to 5 p.m., except state holidays.
 PLEASE NOTE: All correspondence regarding this filing will be sent to the principal office identified on this certificate. FOR OFFICE  SE U NLYO  
 This application must be submitted with a self-addressed, stamped envelope with applicable filing fees.                    SOSBS ARS291103   EV R  .01/04/2023
INSTRUCTIONS 
When to use this form: To be filed with an annual report for any                   Filing Fee and Payment: $3 filing fee; Checks or money orders shall 
partnership with “liability” in the title. Reports are due every year              be made payable to the Secretary of State. Credit cards are not 
between January 1 and April 30.                                                    accepted. 
Late Fee: Any annual report received after April 30 is subject to a late-          Received after April 30: $25 dollar additional penalty fee. 
penalty fee. Enclose an additional $25 dollars upon submission.                    Processing:2-3 weeks; expedited service fee $25 (5 business days). 
Be Accurate: Complete all applicable fields on this form. Write legibly;           Website: All forms are available on the Secretary of State’s website, 
or fill out this application online at www.azsos.gov and print it.                 www.azsos.gov. 
Submission:  Submit this report in duplicate (one original, one copy)              Questions? Call (602) 542-6187; in-state/toll-free (800) 458-5842. 
with a self-addressed, stamped envelope with payment. Any other 
matters, please attach additional sheets with filing. 
 1. Partnership information
 Any Partnership with “Liability” in the Title 
 Name of the Partnership on File                                                                                               Partnership Email Address

 Secretary of State Registration No.            Domestic State of Formation of Foreign Partnership, if applicable                       Date of formation 
                                                                                                                                             /    / 
 a. Principal office informationhis state:
 Street address (P.O. Box or C/O are unacceptable)                                   City                                         State  Zip Code 

 b. Office address maintained in the state of organization
 Address                                                                             City                                         State Zip Code

2. Agent for service of process information                                                                    Phone number (include area code) 
Agent for service of process                                                                                       Optional 
                                                                                                                (       ) 
Arizona address of agent (P.O. Box or C/O are unacceptable)                        City                                          State  Zip Code 
                                                                                                                                   AZ

3. Attestation:
I/we, the undersigned, declare under penalty of law, that I/we have examined the attached report and to the best of my/our knowledge, believe it 
to be true, correct and complete. 
The names and signatures of each CURRENT general partner: 
Name of General Partner 

Signature                                                                                                                        Month Day           Year 

Name of General Partner 

Signature                                                                                                                        Month Day           Year 

Name of General Partner 

Signature                                                                                                                        Month Day           Year 

ArizonaPrintDepartmentForm of StateReset Form              Office of the Secretary of State                                     Adrian Fontes     , Secretary of State 






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