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Limited Liability Company (Llc) Annual Report Form - North Carolina Secretary Of State

LIMITED LIABILITY COMPANY (LLC)

ANNUAL REPORT

NAME OF LIMITED LIABILITY COMPANY:

STATE OF ORGANIZATION: _______

SECRETARY OF STATE L.L.C. ID NUMBER: __________________

FEDERAL EMPLOYER ID NUMBER: _____-________________________

IF THIS IS THE INITIAL ANNUAL REPORT FILING, YOU MUST COMPLETE THE ENTIRE FORM. IF YOUR

LLC’S INFORMATION HAS NOT CHANGED SINCE THE PREVIOUS REPORT, PLEASE CHECK THE BOX

AND COMPLETE LINE 8 ONLY.

1. REGISTERED AGENT & REGISTERED OFFICE MAILING ADDRESS:

2. STREET ADDRESS AND COUNTY OF REGISTERED OFFICE:

3. IF THE REGISTERED AGENT CHANGED, SIGNATURE OF THE NEW AGENT: _____________________________________________________

SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT

4. ENTER PRINCIPAL OFFICE ADDRESS HERE:

ADDRESS-

CITY-

ST-

ZIP-

5. ENTER PRINCIPAL OFFICE TELEPHONE NUMBER HERE: ______________________________________

PLEASE INCLUDE AREA CODE

6. ENTER NAME, TITLE, AND BUSINESS ADDRESS OF MANAGER(S) HERE:

NAME-

ADDRESS-

TITLE-

CITY-

ST-

ZIP-

NAME-

ADDRESS-

TITLE-

CITY-

ST-

ZIP-

NAME-

ADDRESS-

TITLE-

CITY-

ST-

ZIP-

7. BRIEFLY DESCRIBE THE NATURE OF BUSINESS:

8. CERTIFICATION OF ANNUAL REPORT MUST BE COMPLETED BY ALL LIMITED LIABILITY COMPANIES

_________________________________________________________

_____________________________________

FORM MUST BE SIGNED BY A MANAGER OF THE L.L.C.

DATE

_________________________________________________________

_____________________________________

Limited Liability Company (Llc) Annual Report Form - North Carolina Secretary Of State

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