LLP Affidavit Of Compliance For Service On Secretary Of State {UPA-1103}

DO NOT STAPLE Illinois Uniform Partnership Act FORM UPA-1103 January 2004 Limited Liability Partnership Affidavit of Compliance for Service on Secretary of State Submit in duplicate. Please type or print clearly. Secretary of State Department of Business Services Limited Liability Division 357 Howlett Building Springfield, IL 62756 217-524-4952 www.cyberdriveillinois.com Payment must be made by certified check, cashier's check, money order, Illinois attorney's check or Illinois C.P.A.'s check. This space for use by Secretary of State. Date: Assigned File #: Filing Fee: $25 Approved: This space for use by Secretary of State. Federal Employer Identification Number (F.E.I.N.) 1. Registered Limited Liability Partnership name: 2. File number assigned by Secretary of State: 3. Title and case number: First Named Plaintiff Case Number v. First Named Defendant 4. Basis for service on the Secretary of State (check and complete appropriate choice): J a) Registered Limited Liability Partnership has failed to appoint or maintain a registered agent in Illinois. J b) Registered Limited Liability Partnership's registered agent cannot be found with reasonable diligence at the registered office in Illinois. J c) Domestic Registered Limited Liability Partnership's Certificate of Limited Partnership was cancelled ; thus the conditions of paragraphs (a) and (b) exist. Month, Day, Year J d) Foreign Registered Limited Liability Partnership's Application for Admission to Transact Business was cancelled ; thus the conditions of paragraphs (a) and (b) exist. Month, Day, Year J e) Registered Limited Liability Partnership is a Foreign Limited Partnership, which has transacted business in Illinois without having been lawfully admitted to do so (contrary to the provisions of the Revised Uniform Limited Partnership Act). 5. Address to which the undersigned has transmitted, by registered or certified mail, Notice of Service on the Secretary of State and a copy of the process, notice or demand and accompany papers: American LegalNet, Inc. www.USCourtForms.com Printed by authority of the State of Illinois. January 2005 -- 100 -- UPA 15.1 6. Title of the court and county in which the action, suit or proceeding has commenced: 7. Title of document being served: 8. A copy of the process, notice or demand, together with any papers required by law to be delivered with service, are hereby attached. 9. additional pages are attached for filing with this form (filer must complete this blank). 10. The undersigned affirms, under the penalties of perjury, that the facts stated herein are true. Signature of Affiant Date Name (type or print) Daytime Phone Number Signatures must be in BLACK INK on an original document. Carbon copy, photocopy or rubber stamp signatures may only be used on conformed copies. Deliver to the Secretary of State: · Copy of the process, notice or demand · Copy of any papers to be served therewith · Affidavit of Compliance Transmit to the Registered Limited Liability Partnership being served, by certified or registered mail: · Copy of the process, notice or demand · Copy of any papers to be served therewith · Notice of Service on the Secretary of State · Affidavit of Compliance Transmittal to the Registered Limited Liability Partnership being served shall be: 1. At the last registered office of the Registered Limited Liability Partnership as shown on the records of the Secretary of State; and 2. At such address the use of which the person instituting the action, suit or proceeding knows, or on the basis of reasonable inquiry, has reason to believe, is most likely to result in actual notice. This affidavit will be stamped with the date of filing and returned to the affiant as the only proof of filing. American LegalNet, Inc. www.USCourtForms.com Printed by authority of the State of Illinois. January 2005 -- 100 -- UPA 15.1