SUE ANNE GILROY
APPLICATION FOR CERTIFICATE OF
SECRETARY OF STATE
AUTHORITY OF A FOREIGN LIMITED LIABILITY COMPANY
CORPORATIONS DIVISION
302 W. Washington St., Rm. E018
State Form 49464 (10-00)
Indianapolis, IN 46204
Telephone: (317) 232-6576
Approved By State Board Of Accounts 1999
Indiana Code 23-18-11-4 et seq.
INSTRUCTIONS:
Use 8 1/2" x 11" white paper for inserts.
Present original and two (2) copies to address in upper right corner of this form.
FILING FEE: $90.00
Please TYPE or PRINT.
Upon completion of filing, the Secretary of State will issue a receipt.
This application cannot be accepted without an original certificate of existence duly authenticated by the proper authority
from LLC's domicilary state within the last sixty (60) days.
This application cannot be accepted unless a registered agent with an Indiana street address is listed in ARTICLE II.
APPLICATION FOR CERTIFICATE OF AUTHORITY
OF
A FOREIGN LLC
TO TRANSACT BUSINESS IN THE STATE OF INDIANA
The undersigned manager or member of the above ______________________________________________________________ LLC
(State of Domicile)
desiring to effectuate the admittance of the LLC to transact business in the State of Indiana, under the name of
_________________________________________________________________________________ certifies the following facts:
(if using an assumed business name specify name above)
ARTICLE I: Name and Principal Office
Name of LLC ( Must be identical to name shown in Articles of Organization and Amendments thereto)
Address of the principal office of LLC (Number and street, city, state and ZIP code)
ARTICLE II: Registered Office and Registered Agent
Name of the registered agent of the LLC
Indiana address of the registered office of LLC (Number and street, city, state and Zip code)
ARTICLE III: Date of Organization and Duration of Existence
Date of organization in domicilary state
Expected period of duration listed in the Articles of Organization
ARTICLE IV: Management
The Articles of Organization state that the LLC is to be managed by its members.
The Articles of Organization provide for a manager or managers.
In witness whereof, the undersigned being the___________________________________________________ of said LLC executes this
(Manager or member)
Application For Certificate Of Authority, and verifies subject to penalties of perjury, that the facts contained herein are true this
__________________day of __________________________ , _______.
Signature
Printed name
1
State Form 49464 - Application For Certificate Of Authority Of A Foreign Limited Liability Company - Indiana Secretary Of State
Legal
State Form 49464 - Application For Certificate Of Authority Of A Foreign Limited Liability Company - Indiana
Legal
