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SECRETARY OF STATE
FIRST ANNUAL REPORT
STATE CAPITOL
500 E. CAPITOL AVE.
OF A
PIERRE, S.D. 57501
LIMITED LIABILITY COMPANY
(605)773-4845
FAX (605)773-4550
1. The name of the Limited Liability Company is:
2. The state or country under whose law it is organized is: ____________________________________________________________
3. The address of its registered office and the name of its registered agent for service of process in South Dakota is:
4. The address of its principal office is:
5. The names and business addresses of any managers:
6. The dollar amount of the total agreed contributions to the Limited Liability Company is $ _______________________________.*
Date: __________________
________________________
____________________________
(Signature and Title)
* FILING FEE:
F
iling the first annual report if the total agreed contributions o
f the lim d liabili y
ite
t compa
ny are
:
25,000
o
r less
$100
Contribution of:
Over $25,000 and not exceeding
100,000
125
Over $100,000 and not exceeding
500,000
200
Over $500,000 and not exceeding
1,000,000
300
Over $1,000,000 and not exceeding
1,500,000
400
Over $1,500,000 and not exceeding
2,000,000
500
Over $2,000,000 and not exceeding
2,500,000
600
Over $2,500,000 and not exceeding
3,000,000
700
Over $3,000,000 and not exceeding
3,500,000
800
Over $3,500,000 and not exceeding
4,000,000
900
Over $4,000,000 and not exceeding
4,500,000
1,000
Over $4,500,000 and not exceeding
5,000,000
1,100
F
or each additional $500,000, $250 in addition to $1,100
T
he maximum amount charged under this subsection together with any subsequent payments may not exceed sixteen thousand dollars
1.
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LLCAR.DOC
revised 7/1/2003