Professional Limited Liability Company Certificate Form Of Organization - The Commonwealth Of Massachusetts

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The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512
Professional Limited Liability Company
Certificate of Organization
(General Laws Chapter 156C, Section 12)
Federal Identification No.:
_____________________________
(1) The exact name of the limited liability company:
________________________________________________________________________________________________
(2) The street address of the office in the commonwealth at which its records will be maintained:
(3a) The professional service to be rendered:
________________________________________________________________________________________________
(3b) The name and address of each member or manager who will render a professional service in the Commonwealth, and
attach a certificate of the applicable regulating board that each such member or manager who will render the service in the
Commonwealth is duly licensed:
(3c) The limited liability company agrees to abide by and be subject to any conditions or limitations established by any applicable
regulating board including the provision of liability insurance required by G.L. c.156C § 65.
(4) Latest date of dissolution, if specified:
___________________________________________________________________
(5) The name and street address, of the resident agent in the commonwealth:
NAME
ADDRESS

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