Form Sqa - Amendment To The Statement Of Qualification
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1
2C
K
OMMONWEALTH OF
ENTUCKY
ELAINE N. WALKER, SECRETARY OF STATE
_________________________________________________________________________________________________________________________
Division of Business Filings
Amendment to the
Business Filings
PO Box 718
Statement of Qualification
SQA
Frankfort, KY 40602
(502) 564-3490
__________________________________________________________________________________________
Pursuant to the provisions of KRS 14A and KRS 362, the undersigned hereby amends the registration on behalf of the
limited liability partnership named below and, for that purpose, submits the following statements:
1. The name of the limited liability partnership:
_______________________________________________________________________________________________
(Name must be identical to the name of record with the Office of the Secretary of State)
2. The statement of qualification is amended as follows.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
3. This amendment will be effective upon filing, unless a delayed effective date and/or time is provided. The effective date
or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is ______________.
(
Delayed effective
date and/or time)
We declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
_________________________________________________________________________________________________________________________
Signature of Partner
Printed Name
Title
Date
_________________________________________________________________________________________________________________________
Signature of Partner
Printed Name
Title
Date
(04/11)
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