Form Fllc-1 - Application For Registration As A Foreign Limited Liability Company, Form Sra - Addendum To Business Organization And Registration Forms Page 3

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APPLICATION FOR REGISTRATION AS A
Form FLLC-1
FOREIGN LIMITED LIABILITY COMPANY
(Cont.)
*Signature:
Print or type name:
Title:
Date signed:
Complete address of person signing:
To receive your ANNUAL REPORT REMINDER NOTICE by email, please enter your email address here:
.
Shall be executed on behalf of the foreign limited liability company by a person with authority to do so under the
*
laws of the state or other jurisdiction of its formation, or, if the foreign limited liability company is in the hands of a
receiver, executor, or other court appointed fiduciary, trustee, or other fiduciary, it must be signed by that fiduciary.
DISCLAIMER: All documents filed with the Corporation Division become public records and will be available for
public inspection in either tangible or electronic form.
Mail fees, DATED AND SIGNED ORIGINAL AND FORM SRA to: Corporation Division, Department of State, 107
rd
North Main Street, Concord NH 03301-4989. Physical location: 25 Capitol Street, 3
Floor, Concord, NH 03301.
Page 2 of 2
Form FLLC-1 Page 2 (1/2013)

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