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                                    ANNUAL REPORT 
Enter Filing Year 
Secretary of State Office DOMESTIC LIMITED  IABILITY L                  ARTNERSHIPP  
                                    SDCL 48-7A-1003; 59-11-6; 59-11-24.1 
500 E Capitol Ave  
Pierre, SD 57501 
(605)773-4845                                         FILING FEE: $65  
corpinfo@state.sd.us
                                    Additional Fee for Delinquent Reports: $50

1. Business ID and Name:

    Business ID  

    Business Name
2. The jurisdiction under whose law it is formed:               South Dakota 

3. The address of the principal or chief executive office, wherever located.

Actual Street Address                                                       City     State ZIP+4 

Mailing Address, if Different from Street Address                           City     State ZIP+4 

Email Address (Optional) 

4. The South Dakota Registered Agent’s name
South Dakota law permits the registered agent to be either: A)                a noncommercial registered agent (this may be an
individual), B) a commercial registered agent, or C) an office holder.  Complete only one below, either (a) or (b) or (c).

(a) The South Dakota Noncommercial Registered Agent’s name:

Actual Street Address in this State                                         City     State ZIP+4 

Mailing Address in this State, if Different from Street Address             City     State ZIP+4 

Email Address (Optional) 

(b) When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from the
    Commercial Registered Agent.

Commercial Registered Agent Name                                                     CRA# 

(c) Title of the office or other position with the business:
                                                                                            ____________  
Business Office’s Actual Street Address in this State                       City     State ZIP+4 

Mailing Address in this State, if Different from Street Address             City     State ZIP+4 
 _____________________________________________________________________________________________________________________ 
Email Address (Optional)  

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5. The names and business addresses of the partners.

Partner                         Address                                  City                 State ZIP+4 

Partner                         Address                                  City                 State ZIP+4 

Partner                         Address                                  City                 State ZIP+4 

6.Beneficial Interest (optional)

Owner                           Description of Ownership                                      Percentage/Value 

Owner                           Description of Ownership                                      Percentage/Value 

No person may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal 
penalty (SDCL 22-39-36). 

Dated 
                                                            Signature of an authorized person 

Email 
      (Optional)                                            Printed Name 

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                                                                                               Annualreportdomesticllp  Feb 2018 






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