Certificate Of Authority Foreign Limited Liability Company Application

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FOR OFFICE USE ONLY

CERTIFICATE OF AUTHORITY FOREIGN LIMITED

System ID Number

LIABILITY COMPANY APPLICATION

SECRETARY OF STATE

WO Number

SFN 19381 (10-2012)

Filed

The application is accompanied by the following:

*Filing fee of $135

Certification of professional license

*Current CERTIFICATE OF GOOD STANDING or CERTIFICATE OF

Signed Consent to Use Business Name and fee of $10

EXISTENCE duly authenticated by the organizing officer of the state or

Trade Name Registration and fee of $25

country of organization

SEE INSTRUCTIONS FOR FEES, FILING AND MAILING INFORMATION

TYPE OR PRINT LEGIBLY

For reference, see North Dakota Century Code Sections 10-31-01, 10-31-13.1 and 10-32-138.

Type of Limited Liability Company Applying for Certificate of Authority (check one)

3. Federal ID Number

Foreign Business

Foreign Professional

Name of Limited Liability Company EXACTLY as it appears on Certificate of Good Standing from State or Country of Origin

If applicable, provide the trade name and complete the Trade Name Registration form if selected trade name is not already registered in North Dakota.

Only provide the trade name in this line if:

The limited liability company name is not in the form as required of limited liability companies in North Dakota.

The Secretary of State has notified the limited liability company that its name is the same or deceptively similar to a name already registered, and the

limited liability company is unable to obtain Consent to Use Business Name from the previous filer or a certified copy of a final decree of a court of

competent jurisdiction establishing prior right of this limited liability company to use of the name in North Dakota.

The limited liability company does not wish to use or protect its name in North Dakota and chooses to use a name other than its limited liability

company name.

6. Complete Address of Principal Executive Office (Street/RR, PO Box, City, State, ZIP+4) which may not be only a post office box

8. Limited Liability Company Will Expire in State or Country of Origin (check one)

7. State or Country Where Organized

Perpetual

Expires - Specify Date (mm/dd/yyyy):

9. Telephone Number

10. Toll-free Telephone Number

11A. Name of Commercial Registered Agent in North Dakota

11B. Name of Noncommercial Registered Agent in North Dakota

11C. Address of Noncommercial Registered Agent in North Dakota (Street/RR, PO Box, City, State, ZIP+4) May not be only a post office box.

12. Nature of Business or Activities the Limited Liability Company Intends to Conduct in North Dakota

13.

MANAGERS AND GOVERNORS OF THE LIMITED LIABILITY COMPANY

Check box if

Manager

COMPLETE MAILING ADDRESS

also serves

MANAGERS

Street/RR

PO Box

City

State

ZIP+4

as Governor

MANAGING MEMBER

If needed, attach sheet to add names of additional managers or governors.

14.

"The undersigned has read the foregoing application, knows the contents, and believes the statements to be true. I further authorize the Secretary of State

to correct numbers 4, 7, 11A, 11B, and 11C if not correctly reflected. I understand that if I make a false statement in this document, I may be subject to

criminal penalties."

Signature

Date

Daytime Telephone Number and Extension, if

15. Name of Person to Contact about this Document

Email Address

any