New York State 
                                                                         Department of State 
                                                               DIVISION OF CORPORATIONS, 
                                                                         STATE RECORDS AND  
                                                               UNIFORM COMMERCIAL CODE 
                                                                         One Commerce Plaza 
                                                                         99 Washington Ave. 
                                                                         Albany, NY 12231-0001 
                                                                         https://dos.ny.gov                                         
DOCUMENT AND CERTIFICATE COVER SHEET 

Contact Information 
 
Name:   ______________________________________________________________________________ 
 
Mailing Address:_______________________________________________________________________ 
                   
              _____________________________________________________________________________ 
 
Email Address: ______________________________________________________________________ 
 
Phone Number:  ______________________________________________________________________ 
 
Request for Filing of Document 
 
Exact Name of Entity: __________________________________________________________ 
____________________________________________________________ 
 
Document Type:_______________________________________________________________  
                                   (i.e., Certificate of Incorporation, Articles of Organization, Certificate of Amendment, etc.): 
 
Request for Copies or Certificates of Status (Check the appropriate box) 
 
Exact Name of Entity: __________________________________________________________ 

□ Certified Copies of all Documents on File ($10 per document) 

□ Plain Copies of all Documents on File ($5 per document) 

□Certified Copy of _____________________________________________________ ($10 per document) 
                               (specify document) 

□ Plain Copy of ________________________________________________________ ($5 per document) 
                               (specify document) 

□ Certificate of Status - Long Form ($25 per document) 

□ Certificate of Status - Short Form ($25 per document)   
 
Method of Delivery of Filing Receipt or Other Document  

All documents will be returned to the email address listed above with the exception of certified and 
uncertified copies filed before July 1990. 

DOS-2183-f (04/22) 

New York State 
Department of State 
DIVISION OF CORPORATIONS, 
STATE RECORDS AND  
UNIFORM COMMERCIAL CODE 
One Commerce Plaza 
99 Washington Ave. 
Albany, NY 12231-0001 
https://dos.ny.gov 
 
CERTIFICATE OF REGISTRATION 

OF 
 
(Insert Name of Domestic Registered Limited Liability Partnership) 
Under Section 121-1500(a) of the Partnership Law 
 
FIRST: The name of the registered limited liability partnership is: 
 
                                                                                                                                                                             . 

SECOND: The address of the principal office of the partnership without limited partners is: 
                                                                                                                                                          
                                                                                                                                                          . 

THIRD: The profession or professions to be practiced by such partnership without limited  
partners is:  
 
                                                                                                                                                         . 
The partnership is eligible to register as a registered limited liability partnership pursuant to 
Section 121-1500(a) of the Partnership Law. 
FOURTH:  The Secretary of State is designated as agent of the limited liability partnership upon 
whom process against the limited liability partnership may be served.  

The post office address to which the Secretary of State shall mail a copy of any process against the 
limited liability partnership served upon the Secretary of State by personal delivery is: 
 
                               . 
(Optional) The email address to which the Secretary of State shall email a notice of the fact that 
process against the limited liability partnership has been served electronically upon the Secretary of 
State is: 
 
                       . 

FIFTH: The partnership without limited partners is filing this registration for status as a  
registered limited liability partnership. 
 
                X  
(Signature of Partner) (Print or Type Name of Partner) 

 DOS-1526-f (Rev. 12/22) Page 1 of 2 

                            CERTIFICATE OF REGISTRATION 

                                                             OF 
 
                              (Insert Name of Domestic Registered Limited Liability Partnership) 
                              Under Section 121-1500(a) of the Partnership Law 
 
 Filer’s Name and Mailing Address: 

    Name: 

    Company, if Applicable: 

    Mailing Address: 

    City, State and Zip Code: 

 NOTES:   
 1. This form was prepared by the New York State Department of State for filing a certificate of registration for a domestic  
      registered limited liability partnership. This form does not contain all optional provisions under the law. You are not  
      required to use this form.  You may draft your own form or use forms available at legal stationery stores.   
 2. The Department of State recommends that legal documents be prepared under the guidance of an attorney.   
 3. The certificate must be submitted with a $200 filing fee made payable to the Department of State. 
 4. Section 121-1500(p) of the Partnership Law requires a certified copy of the certificate of registration be filed with the  
     licensing authority within 30 days after the filing with the Department of State.  The fee for a certified copy is $10. 
                                                                                                                                
 (For DOS Use Only) 

 DOS-1526-f (Rev. 12/22)                                                                                                        Page 2 of 2