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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 Michele Reagan, 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
SOSBSARS291103 R EV. 0420/ /2018
This application must be submitted with a self-addressed, stamped envelope with applicable filing fees.
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
partnership with “liability” in the title. Reports are due every year shall be made payable to the Secretary of State. Credit cards
between January 1 and April 30. accepted for in person filings.
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 (3 - 5 business
Be Accurate: Complete all applicable fields on this form. Write legibly; days).
or fill out this application online at www.azsos.gov and print it. Website: All forms are available on the Secretary of State’s website,
Submission: Submit this report in duplicate (one original, one copy) www.azsos.gov.
with a self-addressed, stamped envelope with payment. Any other Questions? Call (602) 542-6187; in-state/toll-free (800) 458-5842.
matters, please attach additional sheets with filing.
1.Partnership information
Any Partnership with “Liability” in the Title
Name of the Partnership on File
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
Arizona Department of State Office of the Secretary of State Michele Reagan, Secretary of State