Form Lrg - Registration Or Renewal (Foreign Limited Liability Company) - 2009
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1
2C
K
OMMONWEALTH OF
ENTUCKY
T
G
, S
S
REY
RAYSON
ECRETARY OF
TATE
_________________________________________________________________________________________________________________________
Division of Corporations
Registration or Renewal
LRG
Business Filings
(Foreign Limited Liability Company)
PO Box 718
Frankfort, KY 40602
(502) 564-3490
_________________________________________________________________________________________
Pursuant to the provisions of KRS Chapter 275, the undersigned applies for registration or renewal and, for that purpose,
submits the following statements:
1. The activity request is:
Registration
Renewal
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 mailing address of the limited liability company is
_________________________________________________________________________________________________
S
treet Address or Post Office Box Numbers
City
State
Zip Code
6. The nature of the business of the limited liability company is _______________________________________________
(Please print brief description)
_________________________________________________________________________________________________
_________________________________________________________________________________________________
We/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.
We/I declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct.
__________________________________________________________________________________________
Member, Manger or Authorized Party
Printed Name
Title
Date
(09/09
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