Form Ss366 - Corporation/limited Liability Company Supplemental Initial Report 2011
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1CORPORATION/LIMITED LIABILITY COMPANY SUPPLEMENTAL
Tom Schedler
INITIAL REPORT
Secretary of State
(R.S. 12:25 & R.S. 12:1305)
Enclose $25.00 filing fee
Return to:
Commercial Division
Make remittance payable to
P. O. Box 94125
Secretary of State
Baton Rouge, LA 70804-9125
Do Not Send Cash
Phone (225) 925-4704
Web Site:
1. The name of this company is:
_____________________________________________________________
2. The names and municipal addresses (not a P.O. Box only) of the first directors (corporation) or
managers or members (limited liability company) are:
Name
Address
Name
Address
Name
Address
Name
Address
Corporations:
To be signed by incorporator(s) or shareholder(s):
LLC:
To be signed by each person who signed the Articles of Organization:
Date
(see instructions on back)
SS366 Rev. 09/11
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