Montana Limited Liability Company Annual Report Form (Page 2 of 2) in pdf

INSTRUCTIONS FOR REMOVING MEMBERS OR MANAGERS

DOMESTIC:

Statement of Dissociation- The only time you need to file a Statement of Dissociation is when a

member has dissociated (withdrawn) from the limited liability company. Prepare a separate Statement of

Dissociation to remove each member. The Statement of Dissociation must state the name of the LLC and

the name of the specific member that is being dissociated from the LLC. The Statement of Dissociation

can be signed by the specific member being removed or by one of the other listed members. The filing

fee is $15.00 per Statement of Dissociation, and you must file one statement for each member being

removed.

Managed by Members- If a member is no longer managing the LLC but remains a member, a Statement

of Dissociation is NOT required. Simply do not list their name as a manager.

Managed by Managers- If a manager is no longer managing the LLC and is not a member, a Statement

of Dissociation is NOT required. Simply do not list their name as a manager.

FOREIGN:

Managed by Members of Managers- Members or managers can be removed from the annual report

5. Professional Limited Liability Companies only. I certify that all the members and not less than one-half of the

managers are qualified with the proper licensing authority in Montana or meet higher standards as specified by that

licensing authority.

By my signature below, I, a member of the above limited liability company authorized to execute documents on its

behalf, do state that any and all statements contained herein are true and are based upon actions taken by the LLC in

accordance with the statutes or its articles of organization or operating agreement.

I further state that the LLC remains in existence and has taken the necessary actions during the past year to preserve

the status.

Signature of member

Printed name of member signing

Date

Member address

All information provided, including names and addresses of members or managers, will be made

available on the Secretary of State’s web site or upon request.

Sign and include correct filing fee:

Please send fee and completed report to:

$15.00, if filed on or before April 15th

Brad Johnson (406) 444-3665

$30.00, if filed after April 15th

Secretary Of State

P.O. Box 202802

Helena MT 59620-2802

Make checks payable to Secretary Of State, Helena MT 59620-2802

S:\SHARE\Ely\BSB\Forms\llc\domestic\18-Domestic_Limited_Liability_Company_Annual_Report.doc Revised 11/24/2003

Montana Limited Liability Company Annual Report Form Page 2