Form Dos-1369-F-A - Application For Authority
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1
2
3New York State
Department of State
DIVISION OF CORPORATIONS,
STATE RECORDS AND
UNIFORM COMMERCIAL CODE
One Commerce Plaza
99 Washington Ave.
Albany, NY 12231-0001
APPLICATION FOR AUTHORITY
OF
(Insert name of Foreign Professional Service Limited Liability Company)
Under Section 1306 of the Limited Liability Company Law
FIRST:
The name of the foreign professional service limited liability company is:
.
If the name does not contain the required words or abbreviation pursuant to Section 1306(a)(1) of the
Limited Liability Company Law, the following words or abbreviation is added to the end of its name for
use in this state:
.
SECOND:
The jurisdiction of organization of the foreign professional service limited liability company
is:
.
The date of its formation is:
.
THIRD:
The foreign professional service limited liability company shall practice the profession(s) of
in the State of New York.
FOURTH:
The foreign professional service limited liability company is authorized to practice such
profession(s) in the jurisdiction of its formation.
FIFTH:
The city, incorporated village or town and the county within New York State in which its office is
to be located is:
.
(A city, incorporated village or town and county in New York State must be stated. Please note that the foreign limited liability
company is not required to have an actual physical office in this state.)
SIXTH
: The Secretary of State is designated as agent of the foreign professional service limited
liability company upon whom process against it may be served. The address within or without this state
to which the Secretary of State shall mail a copy of any process served against him or her is:
.
Page 1 of 3
DOS-1369-f-a (Rev. 03/17)
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