FOREIGN-STATEMENT OF REGISTRATION OF FOREIGN[1]

Foreign. STATEMENT OF REGISTRATION OF FOREIGN REGISTERED LIMITED LIABILITY PARTNERSHIP 1 _______________ (Name of Foreign Registered Limited Liability Partnership—last words must be "Registered Limited Liability Partnership", "L.L.P." or "LLP".) 2 _______________ _________(Address of principal office) 3 Florida Registration Number, if applicable: ................................................................................................................................ 4 Name and Florida street address of Registered Agent and registered office for service of process: _______________ _______________ _______________ _______________ (Signature of Registered Agent) 5 Number of Partners: _______________ 6 Number of Partners in FL: _______________ 7 FEI number: _______________ 8 Name and recorded document number of any partner that is an entity other than an individual: .......................................................................................................................................................... ................................................. .......................................................................................................................................................... ................................................. .......................................................................................................................................................... ................................................. Entity Name Document Number 9 Type business is which the partnership engages: .................................................................................................................... _______________ 10 Date foreign registered limited liability partnership first transacted business in Florida: ................................................. 11 Jurisdiction in which foreign registered limited liability partnership is registered:............................................................. 12 Effective date of registration in above named jurisdiction: .................................................................................................... 13 Effective date of foreign limited liability partnership registration in Florida: o As of the date this foreign registration is filed with Secretary of State of Florida; or o A date later than the time of filing which shall not exceed 60 days from the date of filing: _________ (Effective date) 14 Attached to this registration pursuant to s. 620.78(4), F.S., is: o A copy of an insurance policy demonstrating that the partnership complies with s. 620.7851(1)(a), F.S.; or o An affidavit sworn to by a majority in voting interest of the partners that the partnership complies with s. 620.7851(1)(b), F. S. 15 o Attached is a certificate of registration duly authenticated, not more than 90 days prior to delivery of this statement of registration to the Department of State, by the Secretary of State or other official having custody of records in the jurisdiction under the law of which this limited liability partnership was registered. 16 This registration of foreign registered limited liability partnership is executed by either a majority in voting interest of the partners or by one or more partners authorized by a majority in voting interest of the partners. Signed this day _________of ____________, ______. ...................................................................................................... ...................................................................................................... ...................................................................................................... ...................................................................................................... ...................................................................................................... ...................................................................................................... THIS PARTNERSHIP CONTINUES AS A FOREIGN REGISTERED LIMITED LIABILITY PARTNERSHIP FOR ONE (1) YEAR AFTER THE DATE THIS STATEMENT OF REGISTRATION IS FILED. Filing Fee: $_____ per partner (not to exceed $_____) Certified copy: $_____(optional) Certificate of Status: $_____(optional) CR2E063(5/95)