Application For Certificate Of Authority For A Limited Liability Company Page 3

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APPLICATION FOR CERTIFICATE OF AUTHORITY
Page 2
7. The names, titles, and usual business addresses of the current company officials of the limited liability company are:
(use attachment if necessary)
Name and Title
Business Address
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
___________________________________________
_________________________________________________________
8. Attached is a certificate of existence (or document of similar import), duly authenticated by the secretary of state or other official
having custody of limited liability company records in the state or country of formation. The Certificate of Existence must be
less than six months old. A photocopy of the certification cannot be accepted.
9. If the limited liability company is required to use a fictitious name in order to transact business in this State, a copy of the resolution
of its managers adopting the fictitious name is attached.
10. (Optional): Please provide a business e-mail address: ____________________________________________________________.
The Secretary of State’s Office will e-mail the business automatically at the address provided above at no cost when a document
is filed. The e-mail provided will not be viewable on the website. For more information on why this service is offered, please
see the instructions for this document.
11. This application will be effective upon filing, unless a delayed date and/or time is specified: _____________________________.
This the ____day of ________________, 20___
____________________________________________________
Name of Limited Liability Company
____________________________________________________
Signature of Company Official
____________________________________________________
Type or Print Name and Title
Notes:
1. Filing fee is $250. This document must be filed with the Secretary of State.
CORPORATIONS DIVISION
P.O. BOX 29622
RALEIGH, NC 27626-0622
(Revised January 2014)
(Form L-09)

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