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Statement Of Information LLC-12 - California

Statement Of Information Form. This is a California form and can be used in Domestic Limited Liability Companies Limited Liability Companies Secretary Of State .
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Instructions for Completing Form LLC-12 Every domestic and registered foreign limited liability company shall file a Statement of Information with the Secretary of State, within 90 days after the filing of its original Articles of Organization or Application for Registration, and biennially thereafter during the applicable filing period. The applicable filing period for a limited liability company is the calendar month during which its original Articles of Organization or Application for Registration were filed and the immediately preceding five calendar months. A limited liability company is required to file this statement even though it may not be actively engaged in business at the time this statement is due. Changes to information contained in a previously filed statement can be made by filing a new form, completed in its entirety. Legal Authority: Statutory filing provisions are found in California Corporations Code section 17702.09, unless otherwise indicated. All subsequent statutory references are to the California Corporations Code, unless otherwise stated. Failure to file this Statement of Information by the due date will result in the assessment of a $250.00 penalty. (Sections 17713.07(b) and 17713.09; California Revenue and Taxation Code section 19141.) Filing Fees: The fee for filing the initial or biennial Statement of Information is $20.00. Checks should be made payable to the Secretary of State. If this statement is being filed to change any information on a previously filed statement and is being filed outside the applicable filing period, as defined above, no fee is required. Copies: To get a copy of the filed statement, include a separate request and payment for copy fees when the statement is submitted. Copy fees are $1.00 for the first page and $.50 for each additional page. For certified copies, there is an additional $5.00 certification fee, per copy. Complete the Statement of Information (Form LLC-12) as follows: Item 1. Item 2. Item 3. Item 4. Enter the name of the limited liability company exactly as it is of record with the California Secretary of State. Enter the limited liability company number issued by the California Secretary of State. Enter the state or place under the laws of which the limited liability company is organized. If no Statement of Information has ever been filed or if there has been any change to the last Statement of Information filed with the Secretary of State, including a change to any address, complete this form in its entirety. If there has been no change in the information contained in the last Statement of Information filed with the Secretary of State, check the box and proceed to Item 15. Item 5. Item 6. Item 7. Enter the complete street address, city, state and zip code of the limited liability company's principal office. Please do not enter a P.O. Box address or abbreviate the name of the city. Enter the complete mailing address, city, state and zip code of the limited liability company if different from Item 5. This address will be used for mailing purposes. If the company is domestic, enter the complete street address, city and zip code of the office in California that is required to be maintained pursuant to Section 17701.13. If the company is foreign, enter the complete street address, city and zip code of the principle business office in California, if any. Please do not enter a P.O. Box address or abbreviate the name of the city. Enter the name and complete business or residential address of the chief executive officer, if any. Please do not abbreviate the name of the city. Enter the name and complete business or residential address of any manager or managers, appointed or elected in accordance with the Articles of Organization or Operating Agreement, or if no manager has been so elected or appointed, the name and business or residential address of each member. Attach additional pages, if necessary. Please do not abbreviate the name of the city. Enter the name of the agent for service of process in California. An agent is an individual (manager, member or any other person, whether or not affiliated with the company) who resides in California or a corporation designated to accept service of process if the company is sued. The agent must agree to accept service of process on behalf of the company prior to designation. Note: Before a corporation is designated as agent, that corporation must have previously filed with the California Secretary of State, a certificate pursuant to Section 1505. Note, a limited liability company cannot act as its own agent and no domestic or foreign corporation may file pursuant to Section 1505 unless the corporation is currently authorized to engage in business in California and is in good standing in the records of the California Secretary of State. If an individual is designated as agent, complete Items 12 and 13. If a corporation is designated as agent, complete Item 12 and proceed to Item 14 (do not complete Item 13). Item 13. If an individual is designated as agent for service of process, enter a business or residential street address in California. (A P.O. Box address is not acceptable). Please do not enter "in care of" (c/o) or abbreviate the name of the city. If a corporation is designated as agent, leave Item 13 blank and proceed to Item 14. Item 14. Briefly describe the general type of business that constitutes the principal business activity of the limited liability company. Item 15. Type or print the name and title of the person completing this form and enter the date this form was completed. Completed forms along with the applicable fees can be mailed to Secretary of State, Statement of Information Unit, P.O. Box 944230, Sacramento, CA 94244-2300 or delivered in person (drop off) to the Sacramento office, 1500 11th Street, Sacramento, CA 95814. If you are not completing this form online, please type or legibly print in black or blue ink. This form must not be altered. American LegalNet, Inc. www.FormsWorkFlow.com Item 8. Items 9-11. Item 12. State of California Secretary of State STATEMENT OF INFORMATION (Limited Liability Company) L Filing Fee $20.00. If this is an amendment, see instructions. IMPORTANT -- READ INSTRUCTIONS BEFORE COMPLETING THIS FORM 1. LIMITED LIABILITY COMPANY NAME This Space For Filing Use Only File Number and State or Place of Organization 2. SECRETARY OF STATE FILE NUMBER 3. STATE OR PLACE OF ORGANIZATION (If formed outside of California) No Change St
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