Foreign Limited Liability Company Application For Registration - Commonwealth Of Massachusetts Page 2

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(8) The name and business address of each person authorized to execute, acknowledge, deliver and record any recordable
instrument purporting to affect an interest in real property recorded with a registry of deeds or district office of the land court:
NAME
ADDRESS
(9) The name and street address of the resident agent in the Commonwealth:
(10) The latest date of dissolution, if specified: ________________________________________________________________
(11) Additional matters:
Signed by (by at least one authorized signatory): ________________________________________________________________ ,
I __________________________________________________________________________________________________ ,
resident agent of the above limited liability company, consent to my appointment as resident agent pursuant to G.L. c156C § 48
(or attach resident agent's consent hereto).
* Attach a certificate of existence or good standing issued by an officer or agency properly authorized in home state.

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