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

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State of Utah

Department of Commerce

Division of Corporations & Commercial Code

Instructions

Application for Authority to Transact Business for a Foreign Limited Liability Company

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.

Non-Refundable Processing Fee: [ ] Foreign LLC $70.00 [ ] Series LLC $70.00

[ ] Tribal LLC $70.00

1. Exact Name of Foreign Limited Liability Company

2. This limited liability company of the state/country/tribal nation of:

4. Duration:

3. Date of formation/organization in home state:

(Expected Duration)

5. Who/What is the name of the Registered Agent (Individual or Business Entity or Commercial Registered Agent)?:

________________________________________________________________________________________

The address must be listed if you have a non-commercial registered agent. See instructions for further details.

What is a commercial registered agent?

Address of the Registered Agent:

___________________________________________________________

Utah Street Address Required, PO Boxes can be listed after the Street Address

City:

State UT

Zip:

6. Principal place of business:

_________________________________________________________________________________

Street Address

City:

State:

Zip:

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

8. 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.)

9. 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.

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

MANAGER:

MEMBER:

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

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

Authorized Signer Signature:

Name & Title:

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 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.

Optional Inclusion of Ownership Information: This information is not required.

Is this a female owned business?

Yes

Select/Type the race of the owner here

Is this a minority owned business?