Annual Report For Limited Partnership 2016

, Arkansas Secretary of State LIMITED PARTNERSHIP/LIMITED LIABILITY LIMITED PARTNERSHIP ANNUAL REPORT 201 Filing Fee: $15.00 Remittance must accompany this report. Rev. 1 Report Due May (PLEASE TYPE OR PRINT CLEARLY IN BLACK INK)The undersigned, pursuant to A.C.A. 247 4-47-210, sets forth the following: Domestic Foreign 1.Name of the Limited Partnership / Limited Liability Limited Partnership: 2. Street Address (Designated Office in Arkansas): City: State: Zip: Email Address: Mailing Address ( Designated Office in Arkansas, if different than above) : City: State: Zip: 3 .Agent for Service of Process: Street Address: City: State: Zip: Mailing Address ( if different than above) : City: State: Zip: 4 . Tax Contact Name: Mailing Address : City: State: Zip: Zip: Zip: Executed this day of , (Day) (Month) (Year) Authorizing Officer Signature of Authorizing Officer (Type or Print in Black Ink) (Sign in Black Ink) Business and Commercial Services Division 1401 W. Capitol, Suite 250, Little Rock, Arkansas 72201-1094 Make checks payable to Arkansas Secretary of State Phone: 501-682-3409 or Toll Free: 888-233-0325 If a Foreign Limited Partnership/Limited Liability Limited Partnership:Principal Office Street Address:City: State:Principal Office Mailing Address (if different than above):City: State:Jurisdiction under which entity was formed:Fictitious Name or Alternate Name used in Arkansas: American LegalNet, Inc. www.FormsWorkFlow.com