Filing Number: ________________

                    John Thurston, Arkansas Secretary of State
                    LIMITED LIABILITY PARTNERSHIP

                    ANNUAL REPORT 2022

                                                                               Report Due April 1 
                                                                             (PLEASE TYPE OR PRINT CLEARLY IN BLACK INK)
                    The undersigned, pursuant to A.C.A. § 4-46-1003, sets forth the following: 
                                                                             ☐ Domestic ☐ Foreign
1. Name of the Limited Liability Partnership:
2. State or jurisdiction under whose laws Limited Liability Partnership is formed:
3. Street Address (Chief Executive Office):
  City:                                                                      State:                                      Zip: 
  Email Address:
4. Street Address (Office in Arkansas, if different than above):
  City:                                                                      State:                                      Zip: 
5. Agent for Service of Process:
  Street Address:
  City:                                                                      State:                                      Zip: 
  Mailing Address (if different than above): 
  City:                                                                      State:                                      Zip: 
6. Tax Contact Name:
  Mailing Address:
  City:                                                                      State:                                      Zip: 
7. Statement of Qualification Date:
8.List of Partners:
  General Partner/Partner:

  General Partner/Partner:

  General Partner/Partner:

  General Partner/Partner:
  Tax Preparer:

  Executed this ______________ day of _________________________ _____________           ,                                
                            (Day)                                              (Month)                 (Year)  

______________________________________________                                          _____________________________________________
               Authorizing Officer                                                                     Signature of Authorizing Officer  
            (Type or Print in Black Ink)                                                                          (Sign in Black Ink)  
                                   Business and Commercial Services Division 
                                   1401 W. Capitol, Suite 250, Little Rock, Arkansas 72201-1094 
                                   Make checks payable to Arkansas Secretary of State 
                                   Phone: 501-682-3409 or Toll Free: 888-233-0325 
                    Email:  corprequest@sos.arkansas.gov • Website:  www.sos.arkansas.gov

Filing Fee: $15.00 – Remittance must accompany this report.                                                                              Rev. 09/21