Form Upa 1001 PDF Details

Form UPa1001 is an online form submission system used to collect information from a claimant and submit it to the appropriate government agency. This system is available to all claimants who wish to file a workers' compensation claim in Pennsylvania. In order to use this system, you must have an established Pennsylvania employer account number (EAN) and password. You can find more information about how to register for an EAN on the PA Labor and Industry website. Once you have registered for your EAN, you can begin using Form UPa1001 to submit your workers' compensation claim.

QuestionAnswer
Form NameForm Upa 1001
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesillinois act form printable, illinois partnership act form, illinois uniform act form, illinois act form

Form Preview Example

FORM UA

 

 

 

 

Illinois

 

 

September 2019

 

 

 

 

Uniform Partnership Act

 

 

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Department of Business Services

 

 

 

 

 

 

 

 

 

 

 

Limited Liability Division

 

 

 

 

 

 

 

 

 

 

 

 

 

 

501 S. Second St., Rm. 351

 

 

 

 

B N DUCA

 

 

Springfield, IL 62756

 

 

 

 

Type or Print Clearly.

 

 

217-524-8008

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

www.cyberdriveillinois.com

 

 

 

 

 

 

 

 

 

 

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This space for use by Secretary of State.

Federal Employer Identification Number (F.E.I.N.) ____________________________________________________

(Required to file)

1. Partnership name: ________________________________________________________________________

(Name must end with “Registered Limited Liability Partnership,” “Limited Liability Partnership,” “R.L . L . P.,” “L.L.P.,” or “RLLP,” “LLP”)

2. Address of partnership’s chief executive office: __________________________________________________

______________________________________________________________________________________

Street address (Must be a street address. P.O. Box alone is unacceptable.)

______________________________________________________________________________________

City, State, ZIP

3.If different from address in number 2, the street address of an office in this state, if any:

______________________________________________________________________________________

______________________________________________________________________________________

4.Registered agent name and office address: (Must be an Illinois resident or company.)

Registered agent: ________________________________________________________________________

 

First name

Middle initial

Last name

 

 

 

 

IL

Registered office: ________________________________________________________________________

 

Street address

City

ZIP

5. Filing fees:

Filing fee per partner: $100

 

 

Number of partners:

 

 

 

 

Total filing fee:

$

 

 

Fees: $100 for each partner, but not less than $200 or more than $5,000.

(Minimum of two partners.)

Printed by authority of the State of Illinois. September 2019 – 1 – UPA 12.6

UPA-1001

6.Total number of partners:

7.Brief statement of the business in which the partnership engages:

8.The partnership hereby applies for status as a Limited Liability Partnership.

9.Registration application is effective on (check one): o a) the filing date

o b) another date later than but not more than 30 days subsequent to the filing date:

Month, Day, Year

10.The undersigned declares, under penalty of perjury, and the laws of the state of Illinois, that the foregoing is true, correct and complete.

Executed on the ___________of _______________ , ___________ by at least two partners.

Day

Month

Year

Signature

Name and title (type or print)

Signature

Name and Title (type or print)

Street address

City, State, ZIP

Street address

City, State, ZIP

If additional space is required, please continue in the same format

on a plain white 8.5x11” sheet of paper.

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A way to fill out illinois partnership act form portion 1

2. Right after filling in this step, go on to the next stage and complete the essential particulars in these fields - Registered agent name and office, First name, Middle initial, Last name, Registered office, City ZIP, Street address, Filing fees, Filing fee per partner, Number of partners, Total filing fee, and Fees for each partner but not.

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Street address, Month Day Year, and The undersigned declares under of illinois partnership act form

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