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Limited Liability Company Information BLS-700-310 - Washington
| Limited Liability Company Information Form. This is a Washington form and can be used in Corporate Information Liquor Control Board Statewide . |
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State of Washington Business Licensing Service PO Box 9034 Olympia, WA 98507-9034 Telephone 1-800-451-7985 Limited Liability Company Information Must be filed with a Business License Application (or upon request) Type of license(s) requested. Check all that apply: Name of LLC LLC mailing address Street or route, PO box, city, state, zip code UBI number If known Date of formation State of formation Liquor Lottery Dealer/Manufacturer (Vehicles) Telephone number A LLC information LLCs must be registered with the Washington Secretary of State ( ) B LLC members/managers and spouses Name 1st member/manager Address/telephone number Birthdate Social Security number % or units owned Spouse of above 2nd member/manager Spouse of above 3rd member/manager Spouse of above 4th member/manager Spouse of above Please attach additional sheets if necessary, in same format C Certification The undersigned hereby certifies to the Washington State Liquor Control Board, Lottery Commission, and/or Dealer and Manufacturer Services, that the above information is accurate and complete. Misrepresentation of this information is cause for denial of the license applied for. Print name of LLC member or manager Signature of LLC member or manager Title Date X For assistance or to request this document in an alternate format, visit http://business.wa.gov/BLS or call 1-800-451-7985. Teletype (TTY) users may call 360-705-6718. BLS-700-310 (5/18/11) American LegalNet, Inc. www.FormsWorkFlow.com
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