C
O M M O NW E ALT H O F K ENT U CKY
A
L
G
, S
S
LISON
UNDERGAN
RIMES
ECRETARY OF
TATE
____________________________________________________________________________________________________________________________
Division of Business Filings
Articles of Organization
PLC
Business Filings
PO Box 718, Frankfort, KY 40602
Professional Limited Liability Company
(502) 564-3490
Pursuant to KRS 14A and KRS 275, the undersigned applies to qualify and for that purpose submits the following statements:
Article I: The name of the professional limited liability company is
___________________________________________________________________________________________________.
Article II: The street address of the professional limited liability company’s initial registered office in Kentucky is
___________________________________________________ ___________________ ____________ ________________
Street Address Only (No Post Office Box Numbers)
City
State
Zip Code
and the name of the initial registered agent at that office is ____________________________________________________.
Article III: The mailing address of the professional limited liability company’s initial principal office is
___________________________________________________ ___________________ ____________ _______________.
Street Address or Post Office Box Number
City
State
Zip Code
Article IV: The professional limited liability company is to be managed by (must check one):
_____
A. a manager(s).
_____
B. its member(s).
Article V: The profession to be practiced through the professional limited liability company:
___________________________________________________________________________________________________.
Article VI: This application will be effective upon filing, unless a delayed effective date and/or time is provided. The effective
date or the delayed effective date cannot be prior to the date the application is filed. The date and/or time is_____________.
Please indicate the county in which your business operates:
County: ___________________________________________.
To complete the following, please shade the box completely.
Please indicate the size of your business:
Please indicate whether any of the following make up more than fifty percent (50%) of your
Small (Fewer than 50 employees)
business ownership:
Large (50 or more employees)
Women-Owned
Veteran Owned
Minority Owned
Please indicate which of the following best describes your business:
Agriculture
Mining
Services
Construction
Wholesale Trade
Retail Trade
Manufacturing
Finance, Insurance, Real Estate
Public Administration
Transportation, Communications, Electric, Gas, Sanitary Services
Other
I/We declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct.
_____________________________________________ ________________________________ _____________________
Signature of Organizer
Printed Name
Date
_____________________________________________ ________________________________ _____________________
Signature of Organizer
Printed Name
Date
_____________________________________________ ________________________________ _____________________
Signature of Organizer
Printed Name
Date
I, ______________________________________________________, consent to serve as the registered agent on behalf of the limited liability company.
Print Name of Registered Agent
________________________________________________________ ________________________________________ __________________________
Signature of Registered Agent
Printed Name
Date
(0517)