Application For Registration Form (Foreign Llc) - Connecticut Secretary Of State printable pdf download

Application For Registration Form (Foreign Llc) - Connecticut Secretary Of State

APPLICATION

FOR REGISTRATION

FOREIGN LIMITED LIABILITY

COMPANY

Office of the Secretary of the State

30 Trinity Street / P.O. Box 150470 / Hartford, CT 06115-0470 / Rev. 12/1999

Please see reverse for instruction

Space For Office Use Only

1. NAME OF LIMITED

LIABILITY

COMPANY IN STATE OR COUNTRY OF FORMATION:

2. THE NAME UNDER WHICH THE LIMITED

LIABILITY

COMPANY WILL TRANSACT BUSINESS IN

CONNECTICUT,

IF DIFFERENT FROM NAME STATED ABOVE:

3. STATE/COUNTRY

4. DATE OF FORMATION:

FORMATION:

5. DATE LIMITED

LIABILITY

COMPANY

BEGAN TRANSACTING

BUSINESS IN CONNECTICUT:

Month

Day

Year

6. ADDRESS REQUIRED TO BE MAINTAINED

IN PLACE OF FORMATION

OR, IF NOT REQUIRED, THE PRINCIPAL

OFFICE ADDRESS OF THE LIMITED

LIABILITY

COMPANY:

7. THE CHARACTER OF BUSINESS TO BE TRANSACTED

IN CONNECTICUT:

8. APPOINTMENT

OF REGISTERED AGENT FOR SERVICE OF PROCESS:

(Check A or complete B.)

The limited liability company appoints the Secretary of the State of Connecticut and his successors in office

to be its agent upon whom any process, in an action or roceedin a ainst it ma be served.

B. Print or type name of agent

Business address: (P.O. Box is unacceptable)

Residence address: (P.O. Box is unacceptable)

Acceptance of Appointment

Signature of Agent

9. EXECUTION:

The undersigned asserts that the subject limited liability

company is a foreign limited liability

company as defined in Conn.

Gen. Stat. Section 34-lOl(7).

Dated this

day of

7 20

Print or type name of signatory

Capacity of Signatory

Signature

Application For Registration Form (Foreign Llc) - Connecticut Secretary Of State

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