Form Sfn 50239 - Professional Limited Liability Partnership Registration
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1
2
3COMPLETE, PRINT, SIGN, AND FAX OR MAIL
(If paying with credit card complete authorization at bottom of page 3)
FOR OFFICE USE ONLY
PROFESSIONAL LIMITED LIABILITY
ID Number
PARTNERSHIP REGISTRATION
WO Number
SECRETARY OF STATE
SFN 50239 (07-2008)
Filed
By
1.
FILING FEES
2.
This registration is a(n)
$ 35.00
A.
New registration with two managing partners
New registration
Each additional managing partner (not to exceed $250)
3.00
B.
Amended registration
25.00
Amended registration
3.
Attach a certificate from the North Dakota regulating board of the profession involved certifying that each of the partners is licensed to
practice the profession.
For reference, see North Dakota Century Code, Chapters 10-31 and 45-22.
TYPE OR PRINT LEGIBLY
SEE REVERSE SIDE FOR FEES, FILING AND MAILING INSTRUCTIONS.
4. Name of the professional limited liability partnership
5. Federal ID Number
6. Complete mailing address of principal executive office which may not be only a post office box (Street/RR, PO Box if applicable, City, State, Zip+4)
7. Effective date of registration (check box)
8. Telephone Number
9. Toll-Free Telephone Number
At the time of filing with the Secretary of State
At a later date within 90 days as specified _________________________
(month, day, year)
10. The profession practiced in North Dakota
OR
11A. Name of commercial registered agent in North Dakota
11B. Name of noncommercial registered agent in North Dakota
11C. Address of noncommercial registered agent in North Dakota: (Street/RR, PO Box, City, State, Zip+4) May not be only a post office box.
12. Names of all partners who will practice in North Dakota, their Social Security/Federal ID Number's, and their residence addresses
SOCIAL
Check box if
NAME
COMPLETE MAILING ADDRESS
SECURITY/
partner is a
FEDERAL ID
Street/RR
PO Box
City
State
Zip +4
managing
NUMBER
partner
13. "The partnership elects to be a professional limited liability partnership as provided by North Dakota Century Code, Chapters 10-31 and 45-22.
The undersigned managing partners have read the foregoing registration, know the contents thereof, and believe the statements made thereon to be
true. The undersigned further authorizes the Secretary of State to correct number 11A or 11B if not correctly reflected."
Signature
Date
Signature
Date
Signature
Signature
Date
Date
Signature
Date
Signature
Date
14. Name of person to contact about this document
E-Mail Address
Daytime Telephone Number
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