Instructions For Form Dfi/corp/521 - 2005

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INSTRUCTIONS (Ref. sec. 183.1004 or 183.1006, Wis. Stats. for document content)
Submit one original and one exact copy along with the required filing fee determined in item 9 to
the address listed below. Make checks payable to the “Department of Financial Institutions”.
Filing fee is non-refundable. Sign the document manually or otherwise as allowed under sec.
183.0107(1g)(c).
Phone: 608-261-7577
Mailing Address:
Physical Address for Express Mail:
Department of Financial Institutions
Department of Financial Institutions
FAX: 608-267-6813
Division of Corporate & Consumer
Division of Corporate & Consumer
TTY: 608-266-8818
Services
Services
rd
P O Box 7846
345 W. Washington Ave – 3
Fl.
Madison WI 53707-7846
Madison WI 53703
NOTICE: This form may be used to accomplish a filing required or permitted by statute to be
made with the department. Information requested may be used for secondary purposes.
This document can be made available in alternate formats upon request to qualifying
individuals with disabilities.
The name of the foreign limited liability company must include the words “limited liability
company”, “limited liability co.”, or end with the abbreviation “L.L.C.” or “LLC”. If the name
under which the foreign limited liability company is organized does not satisfy that
requirement, it may register under a fictitious name that includes one of the required terms
(see item C). It may also register under a fictitious name if its name is indistinguishable upon
the records of the department from another entity already on record.
1 & 2. (A) For an ORIGINAL certificate, complete items A1 and 2, and items 3 thru 10.
Complete item C, if necessary, to satisfy the name requirements indicated above, and the
Supplement if the company has transacted business in Wisconsin without holding a
certificate of registration.
1 & 2. (B) For an AMENDED certificate, complete items B1 and 2, 3 thru 7 and 9 and 10. A
foreign limited liability company registered in this state must apply for an amended certificate
of registration if it changes any of the following: its name or the fictitious name under which it
is licensed; the state under whose laws it is organized or its date of organization; the vesting
of management of the company. If the company is changing its name or state of
organization, indicate the old name and old state in items A1 and 2 and the new name and
new state in items B1 and 2. Complete item C, if necessary for the new name to satisfy the
name requirements indicated above.
(C) If circumstances require, provide the fictitious name under which the foreign limited
liability company proposes to register in Wisconsin.
3 & 4. The foreign limited liability company must continuously maintain a registered agent
and registered office within Wisconsin. It cannot name itself as its own registered agent. The
address of the registered office must be a physical location. Provide the street number and
name, city and ZIP code in Wisconsin.
5 & 6. Provide the complete address, including street and number, city, state, country and
ZIP code of the office the company is required by law to maintain in its state or country of
organization. If no such office is required, provide the address of the company’s principal
office. Indicate the date of organization of the foreign limited liability company.
3
DFI/CORP/521 (09/05)

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