Form Upa-1003-(D) - Renewal Statement Of Domestic Partnership Page 2
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2UPA-1003- D)
7. Brief statement of the business in which the partnership engages:
8. The partnership hereby applies for continual status as a registered Limited Liability Partnership.
9. The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this renewal
application is to the best of my knowledge and belief, true, correct and complete.
Dated
20
Month, Day
Year
Signature
Street Address
Name and Title (type or print)
City/Town
Partner Name if a Corporation or other Entity
State, ZIP
♻ Printed on recycled paper. Printed by authority of the State of Illinois. November 2009 — 200 — RLLP 2.10
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