APPLICATION FOR CERTIFICATE OF AUTHORITY
Page 2
8. The names, titles, and usual business addresses of the current managers of the limited liability company are:
(use attachment if necessary)
Name
Business Address
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
9. Attached is a certificate of existence (or document of similar import), duly authenticated by the secretary of state or other official
having custody of limited liability company records in the state or country of formation. The Certificate of Existence must be
less than six months old. A photocopy of the certification cannot be accepted.
10. If the limited liability company is required to use a fictitious name in order to transact business in this State, a copy of the
resolution of its managers adopting the fictitious name is attached.
11. This application will be effective upon filing, unless a delayed date and/or time is specified: _________________________
This the ____day of ________________, 20___
____________________________________________________
Name of Limited Liability Company
____________________________________________________
Signature of Manager
____________________________________________________
Type or Print Name
Notes:
1. Filing fee is $250. This document must be filed with the Secretary of State.
CORPORATIONS DIVISION
P. O. BOX 29622
RALEIGH, NC 27626-0622
(Revised January 2002)
(Form L-09)