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Form Sfn 19381a - Certificate Of Authority Foreign Limited Liability Company Application Form - North Dakota Secretary Of State

FOR OFFICE USE ONLY

CERTIFICATE

AUTHORITY

ID #

FOREIGN

LIMITED LIABILITY COMPANY

APPLICATION

WO#

SECRETARY

STATE

Filed

SFN

19381A

(19381

+ 7974)

(10-99)

SEE

REVERSE

SIDE

FOR FEES,

FILING

AND

MAILING

INSTRUCTIONS

TYPE

OR PRINT

Certification of professional

license

The application

is accompanied

Signed

consent

to use of name

and fee of $10

*Certificate of authority fee of $125

Trade name registration and fee of $25

*Signed

consent

of registered

agent

and fee of $10

*Current, ORIGINAL

CERTIFICATE

OF GOOD

STANDING

duly authenticated

by the organizing

officer

of the state

or country

organization.

For reference, see North Dakota Century Code, Sections 10-31-01,

10-31-13.1,

and 10-32-138

2. Identify type of limited liability company applying for certificate of authority

Foreign Business

Foreign Professional

Name of limited liability company exactly

as it appears

on Certificate

of Good

Standing

from

state

country

of origin

4. Federal ID #

5. Name is the same as, or deceptively similar to a name registered

with the North Dakota Secretary of State and the application

for

certificate

of authority

is being submitted

with:

Consent to use of name

Certified copy of a final decree of a court of competent jurisdiction establishing prior right of this limited liability company to use of the name in North Dakota

Trade Name Registration to use a trade name when transacting business in North Dakota

6. Name to be used in North Dakota if different from that in number 3. (SEE INSTRUCTION)

7. Complete address of executive office (Street/RR, PO Box, City, State, Zip+4) which may not only be a post office box number

8. State or country

10.

Telephone

11.

Toll-free telephone

9. Date when limited liability company will expire

where

organized

state

or country

of origin (month,

day,

year)

12. Name of registered

agent in North

Dakota

13.

Federal ID/Social Security # of registered

agent

14. Address of registered

agent in North

Dakota

(Street/RR,

PO Box,

City,

State,

Zip+4)

which

may

not only be a post office

box number

15. Nature of business or activities the limited liability company intends to conduct in the State of North Dakota

16.

MANAGERS

AND

GOVERNORS

OF THE

LIMITED

LIABILITY

COMPANY

Check box if

COMPLETE

MAILING ADDRESS

MANAGERS

manager also

serves as

Street/RR

PO Box

City

State

Zip+4

governor

Member

I f needed,

attach sheet to add names of additional

managers

or governors.

17. "The undersigned

has read the foregoing

application,

knows the contents thereof, and believes the statements are true."

Original signature

Date

Daytime telephone

18. Name of person to contact about this application

Form Sfn 19381a - Certificate Of Authority Foreign Limited Liability Company Application Form - North Dakota Secretary Of State

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