Form Ll0005 - Application For Registration Of A Foreign Limited Liability Company 2010 Page 2
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1
26.
Management Structure (check A or B):
6. Check A or B to
A
Management of the limited liability company is vested in a manager or
show which
managers. Give the name and address of each and every manager AND of each
management structure
and every member who owns a twenty percent or greater interest in the capital or
will be applicable to
your company.
profits of the limited liability company, and check off member and/or manager.
Provide name and
address for each
_______________________________
Name: _________________________________ Name:
person, and check
[ ] member [ ] manager
[ ] member [ ] manager
whether they are
member, manager, or
_____________________________
Address: _______________________________
Address:
both.
___________________________________ ____________________________________
_________________________
City, State, Zip:
City, State, Zip:
7. If the state or
country of formation
_______________________________
Name: _________________________________ Name:
does not require an
address to be
[ ] member [ ] manager
[ ] member [ ] manager
maintained, provide
_____________________________
Address: _______________________________
Address:
the street address of
the statutory agent in
the state or country of
___________________________________ ____________________________________
formation.
_________________________
City, State, Zip:
City, State, Zip:
B
Management of the limited liability company is reserved to the members.
The application must
Give the name and address of each and every member.
be signed by a
member or manager,
_______________________________
Name: _________________________________ Name:
as applicable, or by a
duly authorized agent.
_____________________________
Address: _______________________________
Address:
___________________________________ ____________________________________
Attach a certificate of
existence or document
_________________________
City, State, Zip:
City, State, Zip:
of similar import duly
authenticated within 60
days of its delivery to
_______________________________
Name: _________________________________ Name:
the A.C.C. by the
official having custody
of corporate records in
_____________________________
Address: _______________________________
Address:
the state or country
under whose laws the
___________________________________ ____________________________________
LLC is formed.
_________________________
City, State, Zip:
City, State, Zip:
7. Give the address of the office required to be maintained in the state or country of
formation.
____________________________________________________________________
____________________________________________________________________
Signed this
day of
,
.
___________________________
______________________________________________
Print Name (check one) Member Manager Authorized Agent
Signature
PHONE: ______________________________
FAX: _______________________________
LL:0005
Arizona Corporation Commission
Rev. 04/2010
Page 3 of 3
Corporations Division
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