B
R
FORM LLC-6
WWW.
USINESS
1/2001
Nonrefundable Filing Fee: $50.00
STATE OF HAWAII
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Business Registration Division
1010 Richards Street
Mailing Address: P.O. Box 40, Honolulu, Hawaii 96810
Clear Form
STATEMENT OF CHANGE OF DESIGNATED OFFICE
(Section 428-108, Hawaii Revised Statutes)
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK
The undersigned, submitting this Statement certify as follows:
1.
The limited liability company is (check one):
Domestic
Foreign
2.
The name of the limited liability company is:
_______________________________________________________________________________________________________________
3.
Street address of its current designated office in Hawaii is:
______________________________________________________________________________________________________________
4.
Complete street address (including number, street, city, state, and zip code) of its new designated office in Hawaii is:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
We certify, under the penalties set forth in the Hawaii Uniform Limited Liability Company Act, that we have read the above
statements and that the same are true and correct.
Signed this ____________day of ___________________________________, __________
_______________________________________________________
_________________________________________________________
(Type/Print Name & Title)
(Type/Print Name & Title)
_______________________________________________________
_________________________________________________________
(Signature)
(Signature)
Instructions: Statement must be typewritten or printed in black ink, and must be legible. The statement must be signed and
certified by at least one manager of a manager-managed company or by at least one member of a member-managed company.
All signatures must be in black ink. Submit original statement together with the appropriate fee.
Line 2. State the full name of the limited liability company.
Line 3. State the street address of the current designated office in Hawaii.
Line 4. State the complete street address of the new designated office. Give the number, street, city, state, and zip code. If
no street address is available, state the rural route number or post office box designated by the United States Postal
Service.
Filing Fees: Filing fee ($50.00) is not refundable. Make checks payable to DEPARTMENT OF COMMERCE AND
CONSUMER AFFAIRS. Dishonored Check ($15 fee plus interest charge).
NOTICE: THIS MATERIAL CAN BE MADE AVAILABLE FOR INDIVIDUALS WITH SPECIAL NEEDS. PLEASE CALL THE
DIVISION SECRETARY, BUSINESS REGISTRATION DIVISION, DCCA, AT 586-2744, TO SUBMIT YOUR REQUEST.