!
      State of Rhode Island                                                                                This legal document 
      Department of State - Business Services Division                                                     should be typed.
                                                                                                                          All illegible 
                                                                                                                          documents 
Instructions for Filing                                                                                    will be REJECTED.
Statement of Qualification of Limited Liability Partnership
Section 7-12.1-901 of the General Laws of Rhode Island, 1956, as amended
The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant statutory provision.  
This form and the information provided are not substitutes for the advice and services of an attorney and/or tax specialist.

All filings are public records under RIGL 38-2-1, et seq. This means all information is available to the public by a variety of 
methods including, without limitations, inspections at our office, telephone inquiries and electronically through our online database.

How to complete the form:
1.  State the name of the limited liability partnership. It must         •  Go to our Corporate Database.
   be distinguishable from any name on file with this office.            • Enter the name or ID number of your entity and click 
   The name must include “limited liability partnership,”                  “Search.”
   “registered limited liability partnership,” “l.l.p.,” “r.l.l.p.,”     • Click on the link to your entity record, scroll down, 
   “llp” or “rllp.” You may check name availability on our                 select “All Filings” and then “View Filing.”
   website; however, this does not ensure the name will still            • Identify the desired type of filing and click on “PDF” 
   be available upon filing.                                               under “View PDF” to view and print the record.
2. State the principal office address of the partnership.
3.  State the name of the partnership’s registered agent.             How to maintain your status:
   The registered agent is an individual or entity that will 
   accept legal service for this entity. The agent must be a          The entity is responsible for filing an annual report each 
   RI resident or entity qualified to do business in this state.      calendar year, excluding the year of incorporation, between 
   A RI street address is required, NOT a P.O. Box.                   February 1 and May 1. A courtesy reminder will be mailed 
                                                                      to the registered agent prior to February 1 of each year. Be 
4. List the name and address of each partner. This is                 sure to follow up with your registered agent concerning the 
   optional.                                                          filing of this report. Failure to file an annual report or maintain 
5. By completing and submitting this Statement of                     a registered agent/office will result in revocation proceedings. 
   Qualification the partnership is electing to become a 
   limited liability partnership.                                     Every entity registered with the RI Department of State - 
6.  All Rhode Island limited liability partnerships have a            Business Services Division will have filing requirements with 
   perpetual (ongoing) existence until the partnership is             the Rhode Island Division of Taxation, even if no business 
   formally cancelled with this office. All LLPs are organized        is conducted within Rhode Island for a particular year. Your 
   to conduct any lawful business.                                    business may require additional licensing. Please visit our 
                                                                      website for further information.
7. Check “date received” unless you prefer that the 
   Statement of Qualification go into effect at a later date 
   than when the form is received in this office. Any later           Your entity may also be required to report (and update, if 
   date must be within 90 days of filing.                             necessary) information about the business and its beneficial 
                                                                      owners to the U.S. Department of Treasury’s Financial 
8. A person authorized to execute this application MUST               Crimes Enforcement Network (FinCEN). Visit FinCEN.gov/
   sign and date the form.                                            boi for more information.
How to pay the filing fee:
The filing fee is payable either by mail via check made               Evidence necessary for businesses providing 
payable to RI Department of State or in person via cash,              professional services:
credit card, or check at the Business Services Division, 148 
                                                                      The following professionals require evidence of a current 
W. River Street, Ste. 1, Providence, RI 02904. Contact our 
                                                                      application with the appropriate licensing agency prior to 
office at (401) 222-3040 for further information. 
                                                                      filing with the Department of State.
                                                                         • Engineering (401) 889-5446 bdp.ri.gov 
How to confirm your filing:
                                                                         • Land Surveying (401) 889-5446 bdp.ri.gov 
Entity records are retrievable and viewable through our                  • Architecture (401) 889-5446 bdp.ri.gov 
website. Successful filings will NOT result in a mailed                  • Landscape Architecture (401) 889-5446 bdp.ri.gov
confirmation. Filings that cannot be processed will be posted 
online and then returned. To confirm your submission and 
obtain evidence of your filing:
                                                                                                          FORM 500 - Revised: 01/2024

        State of Rhode Island
        Department of State - Business Services Division

Statement of Qualification of Limited Liability Partnership                                             STAMP 
DOMESTIC Limited Liability Partnership                                                                  FOR
                                                                                                        SECRETARY OF STATE 
        Filing Fee:  $150.00                                                                            USE ONLY

The undersigned, desiring to form, a new limited liability partnership under and by virtue of the powers
conferred by RIGL 7-12.1-901, do execute the following Statement of Qualification of Limited Liability Partnership:
1. The name of the limited liability partnership is:

2. The address of the principal office is:
Street Address 

City/Town                                               State                     Zip Code

3. The name and address of the initial registered agent/office in Rhode Island is:
Agent Name

Street Address (NOT a P.O. Box)

City/Town                                               State                     Zip Code
                                                               RHODE ISLAND

4. The name and address of each partner is (This is optional.):
NAME                                      ADDRESS

                                                               Check this box to indicate an attachment

MAIL TO:
Division of Business Services                                                                           STAMP 
148 W. River Street, Providence, Rhode Island 02904-2615
Phone: (401) 222-3040                                                                                   FOR
                                                                                                        SECRETARY OF STATE 
Website: www.sos.ri.gov                                                                                 USE ONLY

                                                                                  FORM 500 - Revised: 01/2024

5. By filing this statement, the partnership elects to become a limited liability partnership.

6. The partnership has the purpose of engaging in any lawful business, and shall have perpetual existence until cancelled 
or terminated in accordance with RIGL 7-12.1.

7. Date when this Statement of Qualification will be effective: CHECK ONE BOX ONLY

         Date received (Upon filing)

         Later effective date (Date must be no more than 90 days from the date of filing) _____________________
8. This application has been executed by a majority in interest of the partners or by one (1) or more partners authorized to 
execute an application.
Under penalty of perjury, I/we declare and affirm that I/we have examined this Statement of Qualification of Limited Liability 
Partnership, including any accompanying attachments, and that all statements contained herein are true and correct.
Type or Print Name of Authorized Person                                                       Date

Signature of Authorized Person

If you have any questions, please call us at (401) 222-3040, Monday through Friday, 
between 8:30 a.m. and 4:30 p.m., or email corporations@sos.ri.gov.
                                                                                                  FORM 500 - Revised: 01/2024

        State of Rhode Island
        Department of State - Business Services Division

Filer Contact Information
        
In the event our office needs more information in order to complete the filing of this          
document, we ask for the filer’s contact information. All fields are REQUIRED.

Name:                                                                               Date:

Proposed Entity Name:

Street Address:

City:                        State:                                                 Zip Code:

Email Address:                                                                      Phone Number: 

If you have any questions, please call us at (401) 222-3040, Monday through Friday, 
between 8:30 a.m. and 4:30 p.m., or email corporations@sos.ri.gov.
                                                                                         FORM 500 - Revised: 01/2024