ArkansasSecretaryofState                                                                             
                                                                    StateCapitol•LittleRock,Arkansas72201-109       4
                   John Thurston                                                  501-682-3409 • www.sos.arkansas.gov
                   Business&CommercialServices,250VictoryBuilding,1401W.Capitol,LittleRock                      

                                  APPLICATION FOR REGISTRATION  
                           OF LIMITED LIABILITY PARTNERSHIP 
                                            (PLEASE TYPE OR PRINT CLEARLY IN INK) 

1. The name of the limited liability partnership is: ________________________________________________________            
2a. The address of the principal office of the limited liability partnership is: _____________________________________ 
                                                                                            Address Line 1

   _____________________________________________________________________________________________Address Line 2 City State Zip   
2b. The address of an office in Arkansas, if different from the principal office: ___________________________________ 
                                                                                            Address Line 1
   _____________________________________________________________________________________________ 
                   Address Line 2                                   City                   State           Zip

3. The name and address of the agent for service of process for the limited liability partnership is:_________________Name
   _________________________________________________ ________________________ Arkansas ___________
                           Physical Address                                       City                         Zip
4. Statement of intent to be a limited liability partnership: _________________________________________________         
   _____________________________________________________________________________________________

5. Deferred effective date, if any: ____________________________________________________________________

I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class 
C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days. 

Authorizing Officers:________________________________________________________________________________ 
                                                          (Type or Print) 

Authorizing Signature:______________________________________________________________________________ 
                   (Partner)                                                 (Date) 

Authorized Signature:_______________________________________________________________________________ 
                   (Partner)                                                 (Date) 

$50.00 Filing Fee payable to Arkansas Secretary of State                                                       Rev 9/20

                    ArkansasSecretaryofState                                                           
                                                                  1401W.Capitol,           Suite 250, LittleRock , AR 72201
                    John Thurston                                                  501-682-3409 • www.sos.arkansas.gov

                                Annual Report – Contact Information
                                         PLEASE TYPE OR PRINT CLEARLY IN INK 

                                         JURISDICTION (SELECT ONE) 

                                                       DOMESTIC FOREIGN 

                                                 ENTITY TYPE (SELECT ONE)
                                    LIMITED PARTNERSHIP- Due May 1
                                    LIMITED LIABILITY PARTNERSHIP- Due April 1       
                                    LIMITED LIABILITY LIMITED PARTNERSHIP- Due May 1

In order for this entity to receive its annual reporting form, please complete and file with the Office of the Secretary of 
State at the time of filing. 

________________________________________________ _____________________________________________ 
Entity name as used in Arkansas                                 Contact Person 

________________________________________________ _____________________________________________ 
Street Address or Post Office Box Number                        City, State & Zip 

________________________________________________ _____________________________________________ 
Telephone Number                                                E-mail Address

NOTE: Annual Reports will be due the year following filing or qualification in this state.

The information provided herein is true to the best of my knowledge and is made with the intent to file with the 
Arkansas Secretary of State. I understand that the statements made herein are under oath, and that 
knowingly making a false statement herein is a Class C felony (A.C.A § 5-53-102) or a Class A misdemeanor 
(A.C.A. § 5-53-103), or both.

Executed this ___________ day of _____________, __________________. 

Signature                                                       Authorized Officer (Type or Print) 

 $50.00 Filling Fee payable to Arkasas Secretary of State                                                        Rev.9/20