Orm Llc-1052 - Application For A Certificate Of Registration To Transact Business In Virginia As A Foreign Limited Liability Company
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COMMONWEALTH OF VIRGINIA
STATE CORPORATION COMMISSION
LLC-1052
(07/13)
APPLICATION FOR A CERTIFICATE OF REGISTRATION TO
TRANSACT BUSINESS IN VIRGINIA AS A FOREIGN LIMITED LIABILITY COMPANY
1. The name of the foreign limited liability company is (include, if required, any “for use in Virginia” name in parentheses)
_________________________________________________________________________________________
_________________________________________________________________________________________.
2. The foreign limited liability company was formed under the laws of
________________________________________________ on ______________________________________.
(state or other jurisdiction of formation)
(date of limited liability company’s formation)
3. (Mark if applicable:)
The limited liability company was previously authorized or registered with the Commission to transact
business in Virginia as a foreign business entity.
(See instructions.) Set forth the additional required information on an attachment.
4. A. The name of the limited liability company’s registered agent in VIRGINIA is
_______________________________________________________________________________________.
B. The registered agent is (mark appropriate box):
(1) an INDIVIDUAL who is a resident of Virginia and
a member or manager of the limited liability company.
a member or manager of a limited liability company that is a member or manager of the limited liability
company.
an officer or director of a corporation that is a member or manager of the limited liability company.
a general partner of a general or limited partnership that is a member or manager of the limited liability
company.
a trustee of a trust that is a member or manager of the limited liability company.
a member of the Virginia State Bar.
OR
(2)
a domestic or foreign stock or nonstock corporation, limited liability company or registered
limited liability partnership authorized to transact business in Virginia.
C. The limited liability company’s VIRGINIA registered office address, including the street and number, if any,
which is identical to the business office of the registered agent, is
_____________________________________________________________________, VA _____________,
(number/street)
(city or town)
(zip)
which is physically located in the
county or
city of __________________________________________.
5. The post office address, including the street and number, of the limited liability company’s principal office is
_________________________________________________________________________________________.
(number/street)
(city or town)
(state)
(zip)
6. The Clerk of the Commission is irrevocably appointed as the agent of the limited liability company for service of
process if the company fails to maintain a registered agent in Virginia as required by § 13.1-1015 of the Code of
Virginia, the registered agent's authority has been revoked, the registered agent has resigned, or the registered
agent cannot be found or served with the exercise of reasonable diligence.
7. The limited liability company is a “foreign limited liability company” as defined in § 13.1-1002 of the Code of Virginia.
Signed in the name of the foreign limited liability company by:
______________________________________
__________________
____________________________
(signature)
(date)
(telephone number (optional))
________________________________
______________________________________________________
(printed name)
(title (e.g., member or manager)) (see instructions for requisite signature)
Personal Information, such as a social security number, should NOT be included in a business entity document submitted to the Office of the Clerk for
filing with the Commission. For more information, see Notice Regarding Personal Identifiable Information at
REVIEW THE INSTRUCTIONS THAT FOLLOW BEFORE SUBMITTING THIS FORM.
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