Annual Farm Report Limited Liability Company Form - Secretary Of State Office - 2011
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1ANNUAL FARM REPORT
FILE DATE
____________________
Enter Filing Year
Limited Liability Company
Secretary of State Office
RECEIPT NO ___________________
500 E Capitol Ave
Please Type or Print Clearly in Ink
Pierre, SD 57501
Clear Form
(605)773-4845
No Filing Fee
1. L.L.C. Name and Address:
Search for Corporate ID, Name and Agent
Telephone # ____________________
2. The name of the South Dakota Registered Agent _______________________________________________________
______________________________________________________________________________________________
Street Address or Rural Route Box Number in This State and
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address in This State, if Different from Street Address
City
State
ZIP+4
______________________________________________________________________________________________________________________
Email Address
3. List only the changes since the last report of the acreage and location by section, township and county of each lot or
parcel of land in this state owned or leased by the Limited Liability Company.
_______________________________________________________________________________________________
County
Section
Township
Acres
_______________________________________________________________________________________________
County
Section
Township
Acres
_______________________________________________________________________________________________
County
Section
Township
Acres
4. Please complete the appropriate section:
Family Farm
The NUMBER OF MEMBERSHIP INTERESTS owned by person(s) who are
members of a family as defined in SDCL 47-9A-2, one of such shareholders being a
Corporation
family member who is residing on the farm or actively operating the farm, or who has
resided on or has actively operated the farm. (See SDCL 47-9A-14)
_____________
Authorized Farm
The PERCENTAGE of gross receipts of the company derived from rent,
royalties, dividends, interest and annuities.
Corporation
______________%
5. List changes only of names, address and number of membership interests owned by shareholders.
________________________________________________________________________________________________
Name
Address
City
State
Zip
Shares
________________________________________________________________________________________________
Name
Address
City
State
Zip
Shares
________________________________________________________________________________________________
Name
Address
City
State
Zip
Shares
No person may execute this report knowing it is false in any material respect. Any violation is subject to a civil penalty.
Dated ____________________________ ________
______________________________________________
(Signature of an Authorized Person)
Email _____________________________________
______________________________________________
(Printed Name)
*By signing this form you agree to have both the fee and the form processed electronically.
llcfarmreport February 2011
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