Renewal Statement Of Domestic Limited Liability Partnership {UPA-1003-(D)}

DO NOT STAPLE FORM UPA-1003-(D) March 2008 Secretary of State Department of Business Services Limited Liability Division 501 S. Second St., Rm. 357 Springfield, IL 62756 217-785-8960 www.cyberdriveillinois.com Payment must be made by certified check, cashier's check, Illinois attorney's check, Illinois C.P.A.'s check or money order payable to Secretary of State. Illinois Uniform Partnership Act Renewal Statement of Domestic Limited Liability Partnership This space for use by Secretary of State. This space for use by Secretary of State. Date: Assigned File #: Filing Fee: Approved: This renewal application is effective for one year, and will expire if not renewed within 60 days prior to the anniversary date of the original registration with the Secretary of State. DO NOT MAKE CHANGES ON THIS FORM. IF CHANGES ARE NECESSARY, AMENDMENT FORM UPA-1105 AND THE $25 FEE IS REQUIRED. 1. Registered Limited Liability Partnership Name: __________________________________________________ 2. Federal Employer Identification Number (FEIN): ________________________________________________ 3. Effective Date of Initial Registration: ________________________________________________________ 4. Secretary of State Assigned File Number: ______________________________________________________ 5. Address of Chief Executive Office (P.O. Box alone and c/o are unacceptable.): __________________________ ______________________________________________________________________________________ 6. Illinois Registered Agent: __________________________________________________________________ Illinois Registered Office (P.O. Box alone and c/o are unacceptable.): ________________________________ ______________________________________________________________________________________ 7. Total Number of Partners: __________________________________________________________________ Fee Per Partner (x $100): __________________________________________________________________ Total Filing Fee (In no event shall the fee exceed $5,000.): ________________________________________ (page 1) Printed by authority of the State of Illinois. March 2008 -- 200 -- RLLP 2.8 American LegalNet, Inc. www.FormsWorkflow.com 8. Brief statement of the business in which the partnership engages: 9. The partnership hereby applies for continual status as a registered Limited Liability Partnership. 10. The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this renewal application is to the best of my knowledge and belief, true, correct and complete. Dated Month, Day 20 Year 1. Signature 1. Street Address Name and Title (type or print) City/Town Name if a Corporation or other Entity State, ZIP 2. Signature 2. Street Address Name and Title (type or print) City/Town Name if a Corporation or other Entity State, ZIP 3. Signature 3. Street Address Name and Title (type or print) City/Town Name if a Corporation or other Entity State, ZIP 4. Signature 4. Street Address Name and Title (type or print) City/Town Name if a Corporation or other Entity State, ZIP (page 2) Printed by authority of the State of Illinois. March 2008 -- 200 -- RLLP 2.8 American LegalNet, Inc. www.FormsWorkflow.com