Form 49464 - Application Form For Certificate Of Authority Foreign Limited Liability Company - 2016

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APPLICATION FOR CERTIFICATE OF AUTHORITY
SECRETARY OF STATE
FOREIGN LIMITED LIABILITY COMPANY
BUSINESS SERVICES DIVISION
302 West Washington Street, Room E018
State Form 49464 (R7 / 6-16)
Indianapolis, IN 46204
Approved by State Board of Accounts, 2016
Telephone: (317) 232-6576
INSTRUCTIONS:
1. Use 8 ½”x11 white paper for attachments.
2. Please TYPE or PRINT in INK.
3. Please visit our office at
4. Make check or money order payable to the Secretary of State.
5. Submit original completed paperwork to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204.
REQUIREMENTS: Applicant must submit a certificate of existence issued by the proper authority within the last sixty (60) days.
INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD.
Name of business
E-mail address of business (SOS use only)
RETURN DOCUMENTS TO:
Name
Street address, line 1
Street address, line 2
City
State
ZIP code
Telephone number
E-mail address (If different from above – SOS use only)
(
)

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