Form L040.001 - Manager Structure Attachment
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DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
MANAGER STRUCTURE ATTACHMENT
1.
ENTITY NAME – give the exact name of the LLC (foreign LLCs – give name in domicile state or country):
_________________________________________________________________________________________________
2.
A.C.C. FILE NUMBER (if known):______________________________________________________________________
Find the A.C.C. file number on the upper corner of filed documents OR on our website at:
3.
Check one box only to indicate what document the Attachment goes with:
Articles of Organization
Articles of Amendment
Application for Registration
Articles of Amendment to Application for Registration
4.
MANAGERS / MEMBERS – give the name and address of each and every manager and list all members who own
20% or more of the profits or capital of the LLC. Members who own less than 20% may also be listed, but it is not
required. Check the appropriate box or boxes below each person listed – do not check both member boxes. If more
space is needed, use another
Manager Structure Attachment
form.
Name
Name
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
City
State or
Zip
City
State or
Zip
Province
Province
Country
Country
20% or more member
20% or more member
Manager
Less than 20% member
Manager
Less than 20% member
Name
Name
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
City
State or
Zip
City
State or
Zip
Province
Province
Country
Country
20% or more member
20% or more member
Manager
Less than 20% member
Manager
Less than 20% member
Name
Name
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
City
State or
Zip
City
State or
Zip
Province
Province
Country
Country
20% or more member
20% or more member
Manager
Less than 20% member
Manager
Less than 20% member
L040.001
Arizona Corporation Commission – Corporations Division
Rev: 2010
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