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STATE OF MONTANA

This is the minimum information required

(This space for use by the Secretary of State only)

REGISTRATION of NAME

of FOREIGN LIMITED LIABILITY COMPANY

APPLICATION

LINDA McCULLOCH

MAIL:

Secretary of State

P.O. Box 202801

Helena, MT 59620-2801

PHONE:

(406) 444-3665

FAX:

(406) 444-3976

WEB SITE:

sos.mt.gov

Required Filing Fee: $10.00

 24 Hour Priority Handling check box & Add $20.00

 1 Hour Expedite Handling check box & Add 100.00

For the purpose of registering its Limited Liability Company name with the State of Montana, according to

35-8-108,

MCA,

the undersigned foreign Limited Liability Company organized under the laws of any state, territory or country submits the

following statements of fact to the Secretary of State:

1. The exact name of the Limited Liability Company is: ______________________________________________________

2. It is organized under the laws of: _____________________________________________________________________

3. The date of organization is:__________________________________________________________________________

4. The business mailing address of its business office is: _____________________________________________________

__________________________________________

_________________________

City or town

State

Zip code

5. The description of the business: _______________________________________________________________________

6. It submits a certificate of existence currently signed and dated (within 6 months) by the proper official of the state,

territory or country under the laws of which it is organized.

I, HEREBY SWEAR AND AFFIRM, under penalty of law, that the facts contained in this document are true.

____________________________________________________________________

___________________________

Signature of Member/Manager

Date (Mo/Day/Year)

___________________________________________________

Title

Daytime Contact: Phone _____________________________ Email ___________________________________________

NOTE: This registration does not authorize the foreign Limited Liability Company to transact business in the State of

Montana. This is only a name registration which expires on December 31 of each year.

Renewal of the name registration can be processed between October 1 and December 31. Forms are available for this

purpose. Submit to the Secretary of State, P.O. Box 202801, Helena, Montana 59620-2801 with the filing fee of $10.00.

If a formal certificate is desired, remit an additional $5.00 and a written request along with this application.

A copy of the application should be retained in the Limited Liability Company records. To receive a “FILED” copy back,

you will need to submit the original & a copy of this application.

sos.mt.gov/Business/Forms

26-Registration_of_Name_of_Foreign_Limited_Liability_Company.doc

Revised: 11/05/2012

Registration Of Name Of Foreign Limited Liability Company Application - Montana Secretary Of State

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