Foreign Limited Liability Company Registration - Washington Secretary Of State - 2010 Page 2
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SECTION 5
TENURE: (Please check one of the following and indicate the date if applicable)
□
Perpetual existence
□
Specific term of existence _______________ (Number of years or date of termination)
SECTION 6
DATE THE LLC BEGAN DOING BUSINESS IN WASHINGTON STATE:
SECTION 7
NATURE OF BUSINESS IN WASHINGTON STATE:
SECTION 8
NAME AND ADDRESS OF THE WASHINGTON STATE REGISTERED AGENT:
Name: ____________________________________________________________________________
Physical Location Address (required):
______________________________________________________________
City _____________________________________________ WA Zip Code ____________
Mailing or Postal Address (optional):
_______________________________________________________________
City _____________________________________________ WA Zip Code _____________
CONSENT TO SERVE AS REGISTERED AGENT:
I consent to serve as Registered Agent in the State of Washington for the above named Limited Liability
Company. I understand it will be my responsibility to accept Service of Process on behalf of the Limited
Liability Company; to forward mail to the Limited Liability Company; and to immediately notify the Office of the
Secretary of State if I resign or change the Registered Office Address.
X___________________________________________________________________________
Signature of Registered Agent
Printed Name
Date
SECTION 9
NAME, ADDRESS AND SIGNATURE OF MEMBER OR MANAGER:
(If necessary, attach additional names, addresses and signatures)
Name: __________________________________________________________________________________
Address: _______________________________City___________________State
_Zip Code
This document is hereby executed under penalties of perjury, and is, to the best of my knowledge, true and correct.
X_______________________________________________________________________________________
Signature
Printed Name/Title
Date
Phone
Notice: The Washington Secretary of State will be appointed the agent of the foreign limited liability company for service of process under the
circumstances set forth in RCW 25.15.355(2)
LLC – Foreign Registration
Washington Secretary of State
Revised 07/10
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