Application For Certificate Of Authority Foreign Master LLC {56267}

APPLICATION FOR CERTIFICATE OF AUTHORITY FOREIGN MASTER LIMITED LIABILITY COMPANY State Form 56267 (3-17) Approved by State Board of Accounts, 2017 SECRETARY OF STATE BUSINESS SERVICES DIVISION 302 West Washington Street, Room E018 Indianapolis, IN 46204 Telephone: (317) 232-6576 www.sos.in.gov INSTRUCTIONS: 1. Use 8 ½" x 11" white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. REQUIREMENTS: This application must be accompanied by an original certificate of existence duly authenticated by the proper authority from the Master LLC's domiciliary state, within the last sixty (60) days. INFORMATION CONTAINED ON THIS PAGE IS NOT PART OF THE PUBLIC RECORD. Name of business E-mail address of business (SOS use only) RETURN DOCUMENTS TO: Name Street address, line 1 Street address, line 2 City State ZIP code Telephone number E-mail address (If different from above ­ SOS use only) ( ) American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR CERTIFICATE OF AUTHORITY FOREIGN MASTER LIMITED LIABILITY COMPANY State Form 56267 (3-17) Approved by State Board of Accounts, 2017 Indiana Code 23-18.1-7-1 23-18-12-3 FILING FEE: $250.00 APPLICATION FOR CERTIFICATE OF AUTHORITY OF __________________________________________________________________________________________________ The undersigned manager or member desiring to effectuate the admittance of the above-named Master Limited Liability Company (LLC) to transact business in the State of Indiana, certifies the following facts: ARTICLE I ­ NAME AND PRINCIPAL OFFICE Fictitious Name (Only used if name in the application is not available in Indiana or does not meet Indiana's naming convention. The name must include the words Limited Liability Company-S, L.L.C.-S or LLC-S.) Address of Principal Office (number and street ) City State ZIP code ARTICLE II ­ REGISTERED OFFICE AND AGENT The Registered Agent and Registered Office of the Master LLC serve as the agent and office for service of process in Indiana for the Master LLC and each Series of the Master LLC. Name of Registered Agent (Cannot be the Master LLC itself.) Address of Registered Office (number and street or building ­ PO box not accepted) Required: City State ZIP code IN By checking the box, the Signator(s) represent(s) that the Registered Agent named in the application has consented to the appointment of Registered Agent. ARTICLE III ­ DATE OF ORGANIZATION AND DURATION OF EXISTENCE Date of organization in domiciliary state (month, day, year) State of organization The Master LLC is perpetual until dissolution. OR The latest date upon which the Master LLC is to dissolve (month, day, year): ________________________ ARTICLE IV ­ MANAGEMENT The Master LLC will be managed by its manager or managers. The Master LLC will be a single member LLC (optional). Yes No ARTICLE V ­ AUTHORITY TO DESIGNATE SERIES The Master LLC is authorized to transact business in Indiana in accordance with Indiana Code 23-18.1 and is organized under a law that allows for the designation of one or more Series. ARTICLE VI ­ SIGNATURE In witness whereof, the undersigned being the _________________________________________________________ of said Master LLC executes this (manager or member) Application for Certificate of Authority, and verifies subject to penalties of perjury, that the statements contained herein are true, this ______ day of ________________________, 20______. Signature Printed name American LegalNet, Inc. www.FormsWorkFlow.com