Application For Registration Foreign Limited Liability Company - 2010 - State Of Alaska Division Of Corporations, Page 2
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27. The purpose of the company and the 6 digit NAICS industry grouping code that most clearly describe the initial
activities of the company:
Purpose:
NAICS Code:
8. The limited liability company must have at least one member, and list the name, address and % held of each
person/entity owning at least 5% in the company
Member Name
Mailing Address
City
State
ZIP Code
%
Interest
Held
If the company is managed by a manager, list the name, address and % held (if applicable) of each manager in
the company.
Manager Name
Mailing Address
City
State
ZIP Code
%
Interest
Held
9. The PRINTED name and SIGNATURE by a person who is authorized by the law of the state or other
jurisdiction where the company was organized to sign the application:
By signing this application for Certificate of Authority, I attest that the information set forth above is true
and correct.
Signature of Authorized Person
Printed Name
Title
Date
__ / __ / __
To resolve questions with this filing: Please be aware, this form will become public information.
Contact Name
Contact Phone Number
If you have specific legal questions or concerns about this filing, you are strongly advised to consult an attorney or
other professional to assist you.
Mail the completed filing and the $350.00 filing fee in U.S. dollars to:
State of Alaska
Corporations Section
PO Box 110806
Juneau AK 99811-0806
FOR IMMEDIATE PROCESSING, file the Application for Registration for Foreign Limited Liability Company
ONLINE at: Online filing allows you to receive your Certificate of Registration that
can be printed immediately from your home or office computer.
08-435 (Rev. 05/20/10)
Page 2 of 2
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