Form Ll0005 - Application For Registration Of A Foreign Limited Liability Company Page 2
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1
2DO NOT PUBLISH
6.
The Arizona Corporation Commission is appointed as the Statutory Agent for service of
THIS SECTION
process if either of the following occur.
6.
If you do not
A.
An agent has not been appointed under paragraph 5, or if the agent’s authority has
appoint a
been revoked.
statutory agent
when you file the
application, you
B.
The agent cannot be found or served with the exercise of reasonable diligence.
must do so within
sixty days of
filing.
Your
7.
The address of the office required to be maintained in the jurisdiction under the laws of which
failure to do so,
the company is organized, if required; or, if not required, the address of the principal office of
may result in
the company is:
revocation of your
Certificate of
Registration.
7.
If the
jurisdiction
under the law of
Executed this ________ day of ______________________,______.
which your company
is formed, you
must provide the
address of the
principle office
[signature]
of the
company,
in whatever state
or jurisdiction it
,
is located.
[print name]
[title]
The application
must be executed
by a member,
manager or duly
authorized agent.
Phone and Fax are
PHONE
FAX
optional.
The agent must
ACCEPTANCE OF APPOINTMENT BY STATUTORY AGENT
consent to the
appointment by
executing the
consent.
I,
, having been designated to act as statutory
agent, hereby consent to act in that capacity until removed or resignation is submitted in accordance
See A.R.S. §29-601
et seq. for more
with the Arizona Revised Statutes.
.
info
[Signature]
[If signing on behalf of a company serving as statutory
LL0005
agent, print company name here]
Rev. 05/03
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