F
The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512
Foreign Limited Liability Company
Annual Report
(General Laws Chapter 156C, Section 48)
Federal Identification No.:
_____________________________
Year: ____________________
(1a) The exact name of the foreign limited liability company:
________________________________________________________________________________________________
(1b) The exact name of the limited liability company as amended:*
________________________________________________________________________________________________
(1c) If different, the name under which it does business in the Commonwealth:
________________________________________________________________________________________________
(2) The jurisdiction where the limited liability company is organized and the date of organization:
________________________________________________________________________________________________
(3) The general character of business:
________________________________________________________________________________________________
(4) The business address of its principal office:
(5) The business address of its principal office in the Commonwealth, if any :
(6) The name and business address, if different from principal office address, of each manager, if any, and if none, so state:
* If the name of the limited liability company has been amended, attach a certificate evidencing the change issued by an officer or agency
properly authorized in home state.