Kentucky Secretary of State
T
G
REY
RAYSON
_________________________________________________________________________________________________
Division of Corporations
Application for Registration or Renewal
LRG
B
F
USINESS
ILINGS
of Limited Liability Company Name
P.O. Box 718
Frankfort, KY 40602
(502) 564-2848
________________________________________________________________________
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:
1.
Registration
Renewal
(CHECK ONE)
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
______________________________________________________________________
(Brief Description)
______________________________________________________________________.
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.
_________________________________________
Signature
_________________________________________
Type or Print Name & Title
_________________________________________
Street Address
_________________________________________
City
State
Zip Code
Date:___________________________, 20_______
LRG (06/07)
(See attached sheet for instructions)