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DO NOT STAPLE
Form LP 210
January 2005
Filing Fee: $100
Submit in Duplicate
Payment must be made by certified
check, cashier’s check, Illinois attorney’s
check, Illinois C.P .A.’s check or money
order, payable to Secretary of State.
Please do not send cash.
Filing deadline is prior to:
Date (month, day, year)
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 357
Springfield, IL 62756
Illinois Secretary of State
217-785-8960
Department of Business Services
Correspondence regarding this filing will be
Annual Report
sent to the registered agent of the Limited
Partnership unless a self-addressed, stamped
(Illinois or Foreign Limited Partnership or LLLP)
envelope is included.
Please type or print clearly.
1. Limited Partnership Name:
2. Address of office where records required by Section 111 (Illinois) or Section 902 (Foreign) are kept:
Street Address (P .O. Box alone is unacceptable.)
City, State, ZIP , County
3. File number assigned by Secretary of State:
4. Federal Employer Identification Number (F.E.I.N.):
5. Assumed Name, if any:
6. Registered Agent:
Registered Office:
Street Address (P .O. Box alone is unacceptable.)
City, State, ZIP , County
7. State or Jurisdiction of Organization:
Do not make changes on this form. If changes are necessary, Amendment Form
LP 202 (Illinois) or LP 902(A) (Foreign) and a $50 fee are required.
Printed by authority of the State of Illinois. CLP 12.9 — January 2008 — 200