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.
6. By my signature below, I, am authorized to execute documents on behalf of the LLC, and 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.
_________________________________________________
Authorized Signature
_________________________________________________
Printed name of signing Individual
_________________________________
Date (Mo/Day/Year)
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dissociated (withdrawn) from the limited liability company.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 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.
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 or Managers ‐ Members or managers can be removed from the annual report without any
requirements. Simply do not list their name as a manager.
Montana_Limited_Liability_Company_Annual_Report.doc
Revised: 2/11/2009