Form Ftb 3557 Llc - Application For Certificate Of Revivor - Limited Liability Company

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STATE OF CALIFORNIA
Notice Date:
FRANCHISE TAX BOARD
PO BOX 942857
SACRAMENTO CA 95857-2021
Application for Certificate of Revivor – Limited Liability Company
Before the California Franchise Tax Board
In the matter of the application for certificate of revivor of:
Entity Number
:
FEIN Number
:
SOS Number
:
Entity Name
:
Address
:
I request relief from suspension or forfeiture for this entity. I previously submitted or I am enclosing all required
payments, returns, or documents.
Print Name _____________________________________ Title ____________________________________
Signature ______________________________________ Date ____________________________________
Daytime Phone Number (
)
­
Those who can sign this application on behalf of an entity (domestic or foreign) include:
Any stockholder, creditor, member, general partner, or officer.
Any person having an interest in relief from suspension or forfeiture.
Domestic entities can also have a majority of the surviving trustees or directors sign on their behalf.
355748071371
FTB 3557 LLC (REV 07-2013)

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