Application For Certificate Of Authority For A Limited Liability Company Page 2

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State of North Carolina
Department of the Secretary of State
APPLICATION FOR CERTIFICATE OF AUTHORITY
FOR LIMITED LIABILITY COMPANY
§
Pursuant to
57D-7-03 of the General Statutes of North Carolina, the undersigned limited liability company hereby applies for a
Certificate of Authority to transact business in the State of North Carolina, and for that purpose submits the following:
1. The name of the limited liability company is ____________________________________________________________;
and if the limited liability company name is unavailable for use in the State of North Carolina, the name the limited
liability company wishes to use is _____________________________________________________________________.
2. The state or country under whose laws the limited liability company was formed is ______________________________.
3. Principal office information: (Select either a or b.)
a.
The limited liability company has a principal office.
The principal office telephone number: __________________________________________________________.
The street address and county of the principal office of the limited liability company is:
Number and Street: _________________________________________________________________________
City: _________________________ State:_____ Zip Code:____________ County: ____________________
The mailing address, if different from the street address, of the principal office of the corporation is:
Number and Street: _________________________________________________________________________
City: _________________________ State:_____ Zip Code:____________ County: ____________________
b.
The limited liability company does not have a principal office.
4. The name of the registered agent in the State of North Carolina is: ___________________________________________.
5. The street address and county of the registered agent’s office in the State of North Carolina is:
Number and Street:_______________________________________________________________________________
City:_________________________ State: NC
Zip Code:____________ County: ________________________
6. The North Carolina mailing address, if different from the street address, of the registered agent’s office in the State of North
Carolina is:
Number and Street:_______________________________________________________________________________
City:_________________________ State: NC
Zip Code:____________ County: ________________________
CORPORATIONS DIVISION
P.O. BOX 29622
RALEIGH, NC 27626-0622
(Revised January 2014)
(Form L-09)

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