GP 

                                  (For Office Use Only) 

                                           COVER LETTER 

TO: Reinstatement Section 
    Division of Corporations 

SUBJECT:  
                                  (Name of Partnership) 

The enclosed Partnership Registration Statement and fee(s) are submitted for filing. 

Please return all correspondence concerning this matter to the following: 

                 (Name of Person) 

                 (Firm/Company) 

                 (Address) 

                 (City/State and Zip Code) 

For further information concerning this matter, please call: 

                                            at (             ) 
               (Name of Person)                     (Area Code & Daytime Telephone Number) 

    Mailing Address:                                         Street Address: 
    Reinstatement Section                                    Reinstatement Section 
    Division of Corporations                                 Division of Corporations 
    P.O. Box 6327                                            The Centre of Tallahassee 
    Tallahassee, FL 32314                                    2415 N. Monroe Street, Suite 810 
                                                             Tallahassee, FL 32303 

CR2E074 (9/15) 

                                    PARTNERSHIP REGISTRATION STATEMENT 

1. 
                                                     (Name of Partnership) 

2.                                                                         3. 
               (State/County of Formation)                                                  (FEI Number) 

4. 
                                    (Street Address of Chief Executive Office) 

5. 

                               (Street Address of Principal Office in Florida, if applicable) 

6. In accordance with s. 620.8105(1)(c)(1 & 2), Florida Statutes, required partner information is provided in one of the
   following options:
☐     Attached is a list of the names and mailing addresses of ALL partners and Florida Registration Numbers, if other
      than individuals, or:
☐     The name and street address of the agent in Florida who shall maintain a list of the names and addresses
      of all partners:
                                                                           IF OTHER THAN INDIVIDUAL, 
  NAME & FLORIDA STREET ADDRESS                                            FLORIDA REGISTRATION  
 OF FLORIDA AGENT                                                                NUMBER 

If any of the partners are other than individuals, its entity name and Florida Registration Number must be listed below: 

                        Partner Entity Name                                    Florida Document Number 

7. Effective date, if other than the date of filing:                                                                             . 
      (Effective date cannot be prior to the date of filing nor more than 90 days after the date of filing.) 

NOTE:  If the date inserted in this block does not meet the applicable statutory filing requirements, this date will not be listed 
as the document’s effective date on the Department of State’s records.  

The execution of this statement constitutes an affirmation under the penalties of perjury that the facts stated herein are true. 

We are aware that any false information submitted in a document to the Department of State constitutes a third degree felony 
as provided for in s. 817.155, F.S. 

Signed this             day of                                             ,                  . 

Signatures of TWO Partners: 

Typed or printed names of partners signing above: 

                                      Filing Fee:           $50.00 
                                    Certified copy:        $52.50 (optional) 
                                    Certificate of Status: $  8.75 (optional) 

                        Division of Corporations  P.O. Box 6327  Tallahassee, FL  32314