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First Annual Report Of A Limited Liability Company - South Dakota Secretary Of State

SECRETARY OF STATE

FIRST ANNUAL REPORT

STATE CAPITOL

500 E. CAPITOL AVE.

OF A

PIERRE, S.D. 57501

LIMITED LIABILITY COMPANY

(605)773-4845

FAX (605)773-4550

1. The name of the Limited Liability Company is: __________________________________________________________________

___________________________________________________________________________________________________________

2. The state or country under whose law it is organized is: ____________________________________________________________

3. The address of its registered office and the name and address of its registered agent for service of process in South Dakota is:

___________________________________________________________________________________________________________

4. The address of its principal office is: ___________________________________________________________________________

___________________________________________________________________________________________________________

5. The names and business addresses of any managers:

6. The dollar amount of the total agreed contributions to the Limited Liability Company is $ _______________________________.*

Date: __________________

____________________________________________________

(Signature and Title)

* FILING FEE:

AGREED CONTRIBUTION

FEE

Not in excess of $50,000

$ 90

$50,001 to $100,000

$150

In excess of $100,000

$150

for first $100,000 plus $.50

for each additional $1,000

The maximum amount charged may not exceed sixteen thousand dollars ($16,000.).

llcar.doc

First Annual Report Of A Limited Liability Company - South Dakota Secretary Of State