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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 






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