Application For Registration Of A Foreign Professional Limited Liability Company Page 8

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Supplemental Provisions/Information
Text Area: [The attached addendum, if any, is incorporated herein by reference.]
Effectiveness of Filing
(Select either A, B, or C.)
A.
This document becomes effective when the document is filed by the secretary of state.
B.
This document becomes effective at a later date, which is not more than ninety (90) days from
the date of signing. The delayed effective date is:
C.
This document takes effect upon the occurrence of a future event or fact, other than the
th
passage of time. The 90 day after the date of signing is:
The following event or fact will cause the document to take effect in the manner described below:
Execution
The undersigned affirms that the person designated as registered agent has consented to the
appointment. The undersigned signs this document subject to the penalties imposed by law for the
submission of a materially false or fraudulent instrument and certifies under penalty of perjury that the
undersigned is authorized under the provisions of law governing the entity to execute the filing
instrument.
Date:
Signature of authorized person (see instructions)
Printed or typed name of authorized person.
Print
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Form 305
8

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