Account Number
Limited Liability Company Resolution
_________________
I,
, in my official capacity as ___________________of ______________________, a Limited Liability Company (LLC) duly
________________
organized under the laws of the State of
, hereby certify that the following is a true copy of a resolution duly and regularly
______
______________
_______
adopted by the officers of said LLC at the meeting held on this
day of
,
, at which a quorum for the transaction
of business was present and acting, and is still in full force and effect, and appears in the minutes of the meeting:
RESOLVED any one of such partners named below, are hereby fully authorized and empowered to open a brokerage account, transfer, endorse, sell,
assign, set over and deliver any and all securities (including short sales) now or hereafter standing in the name of or owned by this LLC, to purchase
securities (on margin or otherwise), including the purchase and sale of options, and to make, execute, and deliver, under the Resolution of this LLC
any and all written instruments necessary or proper to effectuate the authority hereby confirmed.
I am the sole partner
Certifying Partner’s Signature
Certifying Partner’s Name & Title
Social Security Number
Date of Birth (mm/dd/yyyy)
Address
Telephone Number
Certifying Partner’s Signature
Certifying Partner’s Name & Title
Social Security Number
Date of Birth (mm/dd/yyyy)
Address
Telephone Number
Certifying Partner’s Signature
Certifying Partner’s Name & Title
Social Security Number
Date of Birth (mm/dd/yyyy)
Address
Telephone Number
______
______________
_______
IN WITNESS WHEREOF, I have hereunto set my hand of said LLC this
day of
,
.
Certifying Partner’s Signature
Certifying Partner’s Name
Please Note: COR and/or your broker will verify information provided on this form through a third-party vendor in accordance with the USA Patriot Act.
Cleared Through COR Clearing • 1200 Landmark Center, Suite 800 • Omaha, Nebraska 68102-1916 • (402) 384-6101
• Member FINRA & SIPC
LC23 – 09/12