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: _____________________________________ 
_____________________________________________________________________________________________ 
2b. The address of an office in Arkansas, if different from the principal office: ___________________________________ 
_____________________________________________________________________________________________ 
3. The name and address of the agent for service of process for the limited liability partnership is: __________________
_____________________________________________________________________________________________
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. 11/18

                 ArkansasSecretaryofState                                                    
                                                                 State Capitol • Little Rock, Arkansas 72201-1094
                                                                             501-682-3409 • www.sos.arkansas.gov  
                 John Thurston
                                                                                                                             
                 Business   &CommercialServices,250VictoryBuilding,1401W.Capitol,LittleRock                      

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

                                         JURISDICTION (SELECT ONE) 
                                         □ DOMESTIC    □FOREIGN

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

                                             st
NOTE: Annual Reports will be due on or before April 1  the year following filing or qualification in this state.

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. 

Executed this___________ day of_____________,__________________. 

_____________________________________________________  __________________________________________________ 
Signature                                              Authorized Officer (Type or Print) 

                                                                                                                 Rev. 11/18