Application For Registration Page 3
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3DSCB: 15-8981/8211/8582
Department of State
Corporation Bureau
P.O. Box 8722
Harrisburg, PA 17105-8722
(717) 787-1057
Web site:
Instructions for Completion of Form:
A. Typewritten is preferred. If not, the form shall be completed in black or blue-black ink in order to permit
reproduction. The filing fee for this form is $250 made payable to the Commonwealth of Pennsylvania. Checks
must contain a commercially pre-printed name and address.
B. A foreign limited liability company/limited liability partnership/limited partnership may adopt a name to register and
do business in the Commonwealth of Pennsylvania that is different from the name in its formation documents filed in
its state of domicile. Both boxes 1 and 2 should be completed, even if the name of the entity will be the same in both
jurisdictions.
C. Designators: Limited Partnership: The name may contain the word "company", "limited" or "limited partnership" or
abbreviation. Limited Liability Partnership: The name must contain the word "company", "limited" or "limited
liability partnership" or abbreviation. Limited Liability Company: The name must
contain the word "company,"
"limited" or "limited liability company" or abbreviation.
D. Under 15 Pa.C.S. § 135(c) (relating to addresses) an actual street or rural route box number must be used as
an address, and the Department of State is required to refuse to receive or file any document that sets forth only a post
office box address.
E. The following, in addition to the filing fee, shall accompany this form:
(1) For Limited Liability Company Only: One copy of a completed form DSCB:15-134A (Docketing Statement).
(2) Any necessary copies of form DSCB:17.2.3 (Consent to Appropriation of Name).
(3) Any necessary governmental approvals.
F. Under 15 Pa.C.S. § 8981 or § 8583, upon the filing of this form the applicant shall be authorized to do business in the
Commonwealth of Pennsylvania and no certificate of authority will be issued to the applicant by the Department.
G. This form and all accompanying documents shall be mailed to the address stated above.
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