Form Fpllc-1 - Application For Registration As A Foreign Professional Limited Liability Company, Form Sra - Addendum To Business Organization And Registration Forms Page 2


State of New Hampshire
Filing fee:
$ 50.00
Form FPLLC-1
Fee for Form SRA:
$ 50.00
RSA 304-C:175
Total fees:
& RSA 304-D
Use black print or type.
PURSUANT TO THE PROVISIONS of the New Hampshire Limited Liability Company laws, the
undersigned hereby applies for registration to transact business in New Hampshire and for that purpose
submits the following statement:
FIRST: The name of the professional limited liability company is
SECOND: The name which it proposes to register and do business in New Hampshire is
THIRD: It is formed under the laws of
FOURTH: The date of its formation is
FIFTH: The nature of the business or purposes the professional limited liability company will conduct or
promote in New Hampshire is
SIXTH: The name of the professional limited liability company’s registered agent in New Hampshire is
and the street address, town/city (including zip code and post office box, if any) of its registered office is
(agent's business address in New Hampshire)
SEVENTH: The sale or offer for sale of any ownership interests in this business will comply with the
requirements of the New Hampshire Uniform Securities Act (RSA 421-B).
EIGHTH: All the members and managers and those of its officers as required by the laws of (enter the
state of formation)
and by RSA 304-D:12 are licensed in one or more states,
territories of the United States or the District of Columbia to render a professional service described in the
statement of purpose of the professional limited liability company.
Page 1 of 2
Form FPLLC-1 Page 1


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