Biennial Report {520}

Last Revised: 06/2019Form 520 Toll Free: 877.767.3453 | Central Ohio: 614.466.3910 OhioSoS.gov | business@OhioSoS.gov File online or for more information: OhioBusinessCentral.gov Filing Form Cover LetterPlease return the approval certificate to: Address: City: ZIP Code: Phone Number: E-mail Address: Check here if you would like to receive important notices via e-mail from the Ohio Secretary of State's office regarding Business Services. Check here if you would like to be signed up for our Filing Notification System for the business entity being created or updated by filing this form. This is a free service provided to notify you via e-mail when any document is filed on your business record. Please make checks or money orders payable to: "Ohio Secretary of State" Type of Service Being Requested: (PLEASE CHECK ONE BOX BELOW) Regular Service: Only the filing fee listed on page one of the form is required and the filing will be processed in approximately 3-7 business days. The processing time may vary based on the volume of filings received by our office. Expedite Service 1: By including an Expedite fee of $100.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 2 business days after it is received by our office. Expedite Service 2: By including an Expedite fee of $200.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 1 business day after it is received by our office. This service is only available to walk-in customers who hand deliver the document to the Client Service Center. Expedite Service 3: By including an Expedite fee of $300.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 4 hours after it is received by our office, if received by 1:00 p.m. This service is only available to walk-in customers who hand deliver the document to the Client Service Center. Preclearance Filing: A filing form, to be submitted at a later date for processing, may be submitted to be examined for the purpose of advising as to the acceptability of the proposed filing for a fee of $50.00. The Preclearance will be complete within 1-2 business days. Name (Individual or Business Name): To the Attention of (if necessary): State American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 06/2019Form 520Toll Free: 877.767.3453 Central Ohio: 614.466.3910 OhioSoS.gov business@OhioSoS.gov File online or for more information: OhioBusinessCentral.gov Mail this form to one of the following: Regular Filing (non expedite) P.O. Box 788 Columbus, OH 43216 Expedite Filing (Two business day processing time. Requires an additional $100.00) P.O. Box 1390 Columbus, OH 43216 Form 520 Prescribed by:Biennial Report (Domestic, Professional Association, Domestic or Foreign LLP) Filing Fee: $25 Form Must Be Typed Shareholders of Professional Association Authenticating this form constitutes a certification that all the below listed shareholders are duly licensed or otherwise legally authorized to render the professional services in this state in the profession that is listed above. Name Address (1) Biennial Report of Professional Association (102-YRA) (even-numbered years) (2) Biennial Report of Limited Liability Partnership (103-YRL) (odd-numbered years) If foreign limited liability partnership, provide jurisdiction of formation Indicate Year Indicate Year List ProfessionCHECK ONLY ONE (1) Box Name of Entity Charter or Registration Number Complete the information in this section if box (1) is checkedPage 1 of 2 For screen readers, follow instructions located at this path. American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 06/2019Form 520 Address of the partnership's chief executive office: If the chief executive office is not in Ohio, the address of any office of the partnership in Ohio: If the partnership does not have an office in Ohio, the name and address of the partnership's current agent for service of process: Mailing Address City State Zip Code Mailing Address City State Zip Code Name of Agent Mailing Address City State Zip Code By signing and submitting this form to the Ohio Secretary of State, the undersigned hereby certifies that he or she has the requisite authority to execute this document. Required Report must be signed by an officer of the professional association or partner or authorized representative of the partnership. If authorized representative is an individual, then they must sign in the "signature" box and print their name in the "Print Name" box. Signature By (if applicable) Print Name Complete the applicable information in this section if box (2) is checkedIf authorized representative is a business entity, not an individual, then please print the business name in the"signature" box, an authorized representative of the business entity must sign in the "By" box and print their name in the "Print Name" box.Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Last Revised: 06/2019Form 520 Instructions for Biennial Report This form must be used to file a biennial report for a domestic (Ohio) professional association or a domestic or foreign limited liability partnership. If you wish to file a biennial report for a domestic professional association, please select box 1. Pursuant to Ohio Revised Code 2471785.06, a professional association must file a biennial report in each even-numbered year within thirty days after the thirtieth day of June. Please indicate the year of the filing in box 1. Also, indicate the professional service which must be the same professional service for which the association was organized. If you wish to file a biennial report for a limited liability partnership, please select box 2. Pursuant to Ohio Revised Code 2471776.83, a limited liability partnership must file a biennial report between the first day of April and the first day of July of each odd-numbered year. Please indicate the year of the filing in box 2. If the limited liability partnership is a foreign entity registered in Ohio, please also provide the jurisdiction of formation in the box. Name of Entity and Charter or Registration Number The name and charter or registration number of the professional association or limited liability partnership must be provided. Professional Association Requirements For professional associations only, please provide the names and addresses of all of the shareholders in the association. By completing this portion of the form, the corporation certifies that all of the shareholders in the association are duly licensed, certified, or otherwise legally authorized within Ohio to render the same professional service for which the association was organized. Limited Liability Partnership Requirements For limited liability partnerships only, please provide the street address of the partnership's chief executive office and, if the partnership's chief executive office is not in Ohio, provide the street address of any office of the partnership in this state. If the partnership does not have an office in Ohio, then provide the name and address of the partnership's current agent for service of process. Additional Provisions If the information you wish to provide for the record does not fit on the form, please attach additional provisions on a single-sided, 8 1/2 x 11 sheet(s) of paper. Signature(s) After completing all information on the filing form, please make sure that the form is signed by an authorized representative. If the entity is a professional association, the report must be signed by an officer of the association. If the entity is a limited liability partnership, the report must be signed by a partner or an authorized representative of the partnership. **Note:240 Our office cannot file or record a document that contains a social security number or tax identification number.240 Please do not enter a social security number or tax identification number, in any format, on this form. American LegalNet, Inc. www.FormsWorkFlow.com