STATE OF SOUTH CAROLINA
SECRETARY OF STATE
LIMITED LIABILITY COMPANY
ANNUAL REPORT
FOR THE YEAR OF_________
TYPE OR PRINT CLEARLY IN BLACK INK
The South Carolina Limited Liability Company or Foreign Limited Liability Company hereby delivers to the
Secretary of State its annual report which information is current as of the date of this report. This annual
report is being filed in conformity with Section 33-44-211 of the 1976 South Carolina Code of Laws, as
amended.
1.
Name of the limited liability company:
[ ] Check this box if no information has changed since the filing of the original articles of organization or the
most recently filed annual report.
2.
Check the appropriate box. The applicant is:
a. [ ]
A limited liability company organized under the laws of South Carolina, (a domestic
limited liability company).
b. [ ]
A foreign limited liability company organized in another state or jurisdiction qualified to
transact business in South Carolina. This foreign limited liability company is organized
under the laws of_________________________________________________________
3.
(a) The street address of the current designated office in South Carolina is:
_________________________________________________________________________
Street Address
_________________________________________________________________________
City
County
Zip Code
(b) The name of the company's current agent for service of process is:
_______________________________________________________________________
Name
I hereby consent to the appointment as registered agent
Signature of Registered Agent
(c) The street address of the current agent for service of process in South Carolina is:
_________________________________________________________________________
Street Address
_________________________________________________________________________
City
County
Zip Code