Foreign Professional Limited Liability Companyapplication For Registration - Commonwealth Of Massachusetts

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FP
The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512
Foreign Professional Limited Liability Company
Application for Registration
(General Laws Chapter 156C, Section 48)
Federal Identification No.:
_____________________________
(1a) The exact name of the limited liability company:
________________________________________________________________________________________________
(1b) If different, the name under which it proposes to do business in the Commonwealth of Massachusetts:
________________________________________________________________________________________________
(2) The jurisdiction* where the limited liability company was organized:
________________________________________________________________________________________________
(3) The date of organization in that jurisdiction:
______________________________________________________________
(4a) The professional service to be rendered:
________________________________________________________________________________________________
(4b)
The name and address of each member or manager who will render a professional service in the Commonwealth, and attach a
certificate of the applicable regulating board that each such member or manager who will render the service in the Common
-
wealth is duly licensed:
(4c) The limited liability company agrees to abide by and be subject to any conditions or limitations established by any applicable
regulating board including the provision of liability insurance required by G.L. c.156C § 65.
(5) The business address of its principal office:

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