Kentucky Secretary of State
Division of Corporations
Application for Registration or Renewal
of Limited Liability Company Name
P.O. Box 718
Frankfort, KY 40602
Pursuant to the provisions of KRS Chapter 275, the undersigned hereby applies for
registration or renewal of its company name on behalf of the limited liability company
named below and for that purpose submits the following statements:
2.The name of the limited liability company is
3. The state or country of organization is _____________________________________.
4. The date of organization is ______________________________________________.
5. The nature of the business of the limited liability company is
I certify that, as of the date of filing this application, the above named foreign limited
liability company validly exists as a limited liability company under the laws of the
jurisdiction of its formation.
Type or Print Name & Title
(See attached sheet for instructions)