Form Llc-5 - Limited Liability Company Application For Registration - Secretary Of State
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1File #
State of California
Secretary of State
LIMITED LIABILITY COMPANY
APPLICATION FOR REGISTRATION
A $70.00 filing fee AND a certificate of good standing from an authorized
public official of the jurisdiction of formation must accompany this form.
IMPORTANT – Read instructions before completing this form.
This Space For Filing Use Only
ENTITY NAME
(End the name in Item 1 with the words “Limited Liability Company,” “Ltd. Liability Co.” or the abbreviations “LLC” or “L.L.C.”)
1. NAME UNDER WHICH THE FOREIGN LIMITED LIABILITY COMPANY PROPOSES TO REGISTER AND TRANSACT BUSINESS IN CALIFORNIA
2. NAME OF THE FOREIGN LIMITED LIABILITY COMPANY, IF DIFFERENT FROM THAT ENTERED IN ITEM 1 ABOVE
DATE AND PLACE OF ORGANIZATION
-
-
3.
THIS FOREIGN LIMITED LIABILITY COMPANY WAS FORMED ON
IN
(
)
(
)
(
)
(
)
MONTH
DAY
YEAR
STATE OR COUNTRY
AND IS AUTHORIZED TO EXERCISE ITS POWERS AND PRIVILEGES IN THAT STATE OR COUNTRY.
AGENT FOR SERVICE OF PROCESS
(If the agent is an individual, the agent must reside in California and both Items 4 and 5 must be completed. If
the agent is a corporation, the agent must have on file with the California Secretary of State a certificate pursuant to Corporations Code section 1505 and
Item 4 must be completed (leave Item 5 blank).
4. NAME OF AGENT FOR SERVICE OF PROCESS
5. IF AN INDIVIDUAL, ADDRESS OF INITIAL AGENT FOR SERVICE OF PROCESS IN CALIFORNIA
CITY
STATE
ZIP CODE
CA
APPOINTMENT
(The following statement is required by statute and may not be altered.)
6. IN THE EVENT THE ABOVE AGENT FOR SERVICE OF PROCESS RESIGNS AND IS NOT REPLACED, OR IF THE AGENT CANNOT BE FOUND OR
SERVED WITH THE EXERCISE OF REASONABLE DILIGENCE, THE SECRETARY OF STATE OF THE STATE OF CALIFORNIA IS HEREBY APPOINTED
AS THE AGENT FOR SERVICE OF PROCESS OF THIS FOREIGN LIMITED LIABILITY COMPANY.
OFFICE ADDRESSES
(Do not abbreviate the name of the city.)
7. ADDRESS OF THE PRINCIPAL EXECUTIVE OFFICE
CITY AND STATE
ZIP CODE
8. ADDRESS OF THE PRINCIPAL OFFICE IN CALIFORNIA, IF ANY
CITY
STATE
ZIP CODE
CA
EXECUTION
9.
I DECLARE I AM THE PERSON WHO EXECUTED THIS INSTRUMENT, WHICH EXECUTION IS MY ACT AND DEED.
SIGNATURE OF AUTHORIZED PERSON
DATE
TYPE OR PRINT NAME OF AUTHORIZED PERSON
TITLE OF AUTHORIZED PERSON
RETURN TO
(Enter the name and the address of the person or firm to whom a copy of the filed document should be returned.)
10. NAME
FIRM
ADDRESS
CITY/STATE/ZIP
LLC-5 (REV 03/2005)
APPROVED BY SECRETARY OF STATE
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