Application For Authority To Transact Business For A Foreign Limited Liability Company Form

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For Office Use Only

File Number ____________________

State of Utah

DEPARTMENT OF COMMERCE

Non-Refundable Processing Fee:

[ ] Foreign LLC

$52.00

Division of Corporations & Commercial Code

[ ] Series LLC

$52.00

Application for Authority to Transact Business for a Foreign

Limited Liability Company

Print Form

Clear Form

A Certificate of Good Standing/Existence from the state of organization dated no earlier than ninety (90) days prior to filing with the Division is

attached.

1. Exact Name of Foreign Limited Liability Company

2. This limited liability company of the state or country of:

3. Date of formation or organization in home state:

4. Duration:

5. The Registered Agent in Utah is:

Signature:

Sign here after the form is printed

6. The address of the registered office in Utah is:

________________________________________________________________

Utah Street Address Required

Street Address

City

State UT

Zip

7. Principal place of business:

________________________________________________________________

Street Address

City

State

Zip

8. The nature of the business or purpose(s) to be conducted or promoted in Utah:

9. The limited liability company shall use as its name in Utah:

__________________________________________________________________________________________________________

(The limited liability company shall use its name as set forth at the top of this form unless the name is not available for use in Utah.)

10. Clear indication of who is managing the company is required.

10a. Is this foreign limited liability company manager-managed? _____Yes, ______No.

If YES, you must list the name and business or residence street address of each manager.

Position

Name

Address

City

State

Zip

MANAGER:

10b. Is this foreign limited liability company member-managed? _____Yes, _____No.

If YES, you must list the name and business or residence street address of each member.

Position

Name

Address

City

State

Zip

MEMBER:

Please list additional managers/members (if any) on an attachment

11. If a foreign entity is a member or manager, you must list the home state where the entity is registered:

12. The date the limited liability company intends to first transact business in Utah:

Under penalties of perjury, I declare as a manager or member with management authority of this limited liability company having authority to sign

hereto, that this application for authority to transact business has been examined by me and is, to the best of my knowledge and belief, true, correct

and complete.

_______________________

________________________

Sign here after the form is printed

Limited Liability Company Authorized Signer Signature

Name & Title

Under GRAMA {63-2-201}, all registration information maintained by the Division is classified as public record. For confidentiality purposes,

you may use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.

Division's Website:

Mail In: PO Box 146705

Mailing/Faxing Information:

/contactus.html