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Application For Registration Foreign Limited Liability Company - 2010 - State Of Alaska Division Of Corporations,

State of Alaska

DO NOT STAMP ABOVE THIS BOX

Division of Corporations, Business and Professional Licensing

CORP

CORPORATIONS SECTION

PO Box 110806

Juneau, AK 99811-0806

Phone: (907) 465-2550

Fax: (907) 465-2974

Website:

(OFFICE USE ONLY)

APPLICATION FOR REGISTRATION

Foreign Limited Liability Company

Pursuant to the provisions of the Alaska Statutes, the undersigned limited liability company applies for a Certificate

of Registration and, for that purpose, submits the following statement:

1. The legal name of the limited liability company:

The name of a limited liability company must contain the words

"limited liability company" or the abbreviation "L.L.C.," or "LLC":

The assumed name elected to use in Alaska if the legal name in not available:

2. State of domicile, date of organization, and the period of duration in the state or country of domicile:

Duration is

the length of time the company expects to exist. It may be a specific future date (mm/dd/yyyy) of less than 100 years or

“perpetual”.

State of Domicile:

Date of Organization:

Duration:

(mm/dd/yyyy)

The limited liability company is active and in good standing in the state of domicile.

3. Registered Agent name and address:

Must have a physical and mailing address in Alaska.

Name:

Mailing Address:

ZIP Code:

Physical Address if Mailing

Address is a Post Office

Box:

City:

ZIP Code:

4. The Department is appointed the agent of the company for service of process if the foreign limited liability

company fails to appoint or maintain a registered agent under AS 10.50.635. Which in part states; A foreign

limited liability company registered under this chapter shall have and continuously maintain in the state a

registered agent and address.

5. Address of the administrative office of the company wherever located:

Mailing Address:

Physical Address if Mailing

Address is a Post Office

Box:

City:

ZIP Code:

6. Email Address:

08-435 (Rev. 05/20/10)

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Application For Registration Foreign Limited Liability Company - 2010 - State Of Alaska Division Of Corporations,

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