Form Ll0005 - Application For Registration Of A Foreign Limited Liability Company Page 2

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DO NOT PUBLISH
6.
The Arizona Corporation Commission is appointed as the Statutory Agent for service
THIS SECTION
of process if either of the following occur.
6.
If you do not
A.
An agent has not been appointed under paragraph 5, or if the agent’s authority
appoint a
statutory agent
has been revoked.
when you file the
application, you
must do so within
B.
The agent cannot be found or served with the exercise of reasonable diligence.
sixty days of
filing.
Your
failure to do so,
7.
The address of the office required to be maintained in the jurisdiction under the laws of
may result in
revocation of your
which the company is organized, if required; or, if not required, the address of the
Certificate of
principal office of the company is:
Registration.
7.
If the
jurisdiction
under the law of
which your company
is formed, you
must provide the
Executed this ________ day of ______________________,______.
address of the
principle office
of the
company,
in whatever state
or jurisdiction it
is located.
[signature]
The application
must be executed
by a member,
,
manager or duly
[print name]
[title]
authorized agent.
PHONE
FAX
Phone and Fax are
optional.
The agent must
consent to the
ACCEPTANCE OF APPOINTMENT BY STATUTORY AGENT
appointment by
executing the
consent.
I,
, having been designated to act as statutory
agent, hereby consent to act in that capacity until removed or resignation is submitted in
accordance with the Arizona Revised Statutes.
See A.R.S. §29-601
et seq. for more
[Signature]
.
info
[Print name]
[If signing on behalf of a company serving as
statutory agent, print company name here]
LL0005
Rev. 10/03

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