Application To Adopt Change Or Cancel Assumed Name {LP 108.5}

Form August 2012 LP 108.5 Illinois Uniform Limited Partnership Act FILE # This space for use by Secretary of State. Secretary of State Department of Business Services Limited Liability Division 501 S. Second St., Rm. 357 Springfield, IL 62756 217-524-8008 www.cyberdriveillinois.com Payment may be made by check payable to Secretary of State. If check is returned for any reason this filing will be void. Please do not send cash. Application to Adopt, Change or Cancel Assumed Name SUBMITINDUPLICATE Please type or print clearly. Filing Fee: · $150 for each year or part thereof ending in 0 or 5 · $120 for each year or part thereof ending in 1 or 6 · $90 for each year or part thereof ending in 2 or 7 · $60 for each year or part thereof ending in 3 or 8 · $30 for each year or part thereof ending in 4 or 9 · $50 to cancel or change an assumed name. Approved: 1. Limited PartnershipName: ________________________________________________________________________ 2. State or other Jurisdiction under the laws of which the Limited Partnership is formed (check one): o Illinois (domestic) o Foreign (specify) ____________________________________________________________________________ 3. To Adopt -- The above-named Limited Partnership intends to adopt and transact business under the Assumed Name of: ______________________________________________________________________________________________ 4. To Change -- The above-named Limited Partnership intends to cease transacting business under the Assumed Name of: ______________________________________________________________________________________________ and to commence transacting business under the new Assumed Name of: __________________________________________ __________________________________________________________________________________________________________________ 5. To Cancel -- The above-named Limited Partnership intends to cease transacting business under the Assumed Name of: ______________________________________________________________________________________________ One General Partner must sign the Application to Adopt, Change or Cancel Assumed Name. The undersigned affirms, under penalties of perjury, that the facts stated herein are true, correct and comlete. Dated: ___________________________________ Month, Day, Year __________________________________________ General Partner Name if corporation or other entity ________________________________________ Signature __________________________________________ Name and Title (type or print) Dated: ___________________________________ Month, Day, Year __________________________________________ General Partner Name if corporation or other entity Signatures must be in black ink on an original document. Carbon copy, photocopy or rubber stamp signatures may only be used on conformed copies. Printed on recycled paper. Printed by authority of the State of Illinois. August 2012 -- 1 -- CLP 8.10 American LegalNet, Inc. www.FormsWorkFlow.com