Application For Reinstatement {LLD-10}

FILE ONE ORIGINAL (Two if you want a filed stamped copy returned to you.)FILING FEE: See fees below.**** In accordance with West Virginia Code, the undersigned organization adopts the following **** Articles of Reinstatement of its Limited Liability Company.*Important Legal Notice Regarding Signature: Per West Virginia Code 24731B-2-209 . Liability for false statement in filed record. If a record authorized orrequired to be filed under this chapter contains a false statement, one who suffers loss by reliance on the statement may recover damages for the loss from a person who signed the record or caused another to sign it on the person's behalf and knew the statement to be false at the time the record was signed. Important Note: This form is a public document. Please DO NOT provide any personal identifiable information on this form such as social security numbers, bank account numbers, credit card numbers, tax identification or driver's license numbers. Date: Title: Signature: Signature of person executing document (see below *Important Legal Notice Regarding Signature): Phone: Name:Contact name and number of person to reach in case of problem with filing (optional, however, listing one may help to avoid a rejection of filing if there appears to be a problem with the document): Total Amount Enclosed: $ All organizations, except Limited Liability Partnerships: Must include with the reinstatement documents a payment of $25 for the reinstatement application fee, a late fee of $50 (for a profit organization) or $25 (for a non-profit organization), plus $25 for the delinquent annual report fee that is being submitted. Each year an an annual report is due by July 1st. REQUIRED - Attached is the annual report required to be filed by the company. The report MUST BE SIGNED. The organization states that the reason for revocation or dissolution has been eliminated and that the name satisfies the name requirements as required in the West Virginia Code (this box must be checked). 3.Read the following statements and check the boxes accordingly (Be sure you have met ALL the requirements below toreinstate before submitting your application to avoid it being rejected and returned to you as incomplete.): 2.Date of revocation or administrative dissolution by the WV Office of Secretary of State: 1.The name of the organization is:225For profit total amount = $100225Non-profit total amount = $75 Form LLD-10 Rev. 6/2018WEST VIRGINIA APPLICATION FOR REINSTATEMENT OF REVOKED OR ADMINISTRATIVELY DISSOLVED LIMITED LIABILITY COMPANYWest Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov To obtain a Letter of Good Standing: West Virginia State Tax Department Phone Numbers: - Visit MyTaxes at https://mytaxes.wvtax.gov/ . ATTN:240 TPS - Support Unit (304) 558-3333 - Select "Request Letter of Good Standing." PO Box 885 (800) 982-8297 - Fill out the online request form GSR-01. Charleston, WV240 25323-0885 REQUIRED - The organization has obtained a Letter of Good Standing from the West Virginia State Tax Department, which recites that all taxes owed by the company have been paid, AND the letter, or a copy of the letter, is hereby attached to this application for reinstatement. Your application will be REJECTED and RETURNED to you as incomplete if the letter is not included with this application. Visit the "MyTaxes" web site at https://mytaxes.wvtax.gov/ . Select the "Request Letter of Good Standing" link to complete the online request form GSR-01. NOTE: The State Tax Dept. no longer accepts paper requests, unless the request is for a third party release or the taxpayer has no access to a computer. If no access, contact the Tax Dept. at the contact information below to request a paper form. Important Note: This form is a public document. Please DO NOT provide any personal identifiable information on this form such as social security numbers, bank account numbers, credit card numbers, tax identification or driver's license numbers. 1.Name of the Organization: 2.Incorporation or Qualification Date: In which state: County Code: Business Class Code:(If you do not know the codes, you may leave this section blank.) Zip Code: State: City: Address 1: 3.County: Address 2:4.Principal Office Address:5.Principal Mailing Address: Zip Code: State: City: Address 2: Address 1:6.Name and Mailing Address ofperson (agent) to whom noticeof legal process may be sent, ifany: Zip Code: State: City: Address 2: Address 1: Name: *If new agent, furnish new agent's signature: 7.Business E-mail Address where business correspondence may be sent:10.Total number of West Virginia residents:9.Total number of employees: 8.Website address of the business, if any (ex: yourdomainname.com): 11.Is this a minority owned business? 13.Do you own or operate more than onebusiness in West Virginia?b.Located in how many West Virginia counties?If "Yes"... a. How many businesses?12.Is this a woman owned business? Yes No Decline to answer* Answer a. and b. below. Yes No Decline to answer Yes No Decline to answer Annual Report for filing year(enter the CURRENT calendar year) for Limited Liability Companies (per WV Code 59-1-2a) **** IMPORTANT **** In the following sections (items #15 OR #16), answer ONLY the item which applies to your entity type, either MEMBER-MANAGED OR MANAGER-MANAGED, NOT BOTH. If you are unsure which type the LLC is registered as, please contact the West Virginia Secretary of State's Office Business and Licensing Division for further assistance at 1-877-826-2954 or 304-558-8000 to determine its management structure. b.Is(Are) the owner(s) of the organization a United States Armed Forces veteran(s)? 14.Veteran Employees and Veteran Owner Information:a.Does your organization employ individuals who are United States Armed Forces veterans? *If "Yes," enter the total number of veterans it employs. Yes* No Decline to answer Yes No Decline to answer Title/Capacity of signer: Phone: Signature: 17.REPORT MUST BE SIGNED for the organization by a: (1) MEMBER of a member-managed company OR (2) a MANAGER of a manager-managed company. Date: Member Name No. & Street Address City State Zip Code 15.MEMBER Information: Complete this section ONLY if you were set up as a MEMBER-managed company. List the name and address ofeach member having signature authority to sign filings (attach additional page if necessary): Manager Name No. & Street Address City State Zip Code 16.MANAGER Information: Complete this section ONLY if you were set up as a MANAGER-managed company. List the name and addressof each manager having signature authority to sign filings (attach additional page if necessary):... OR ... MAKE CHECK, MONEY ORDER, OR CASHIER'S CHECK PAYABLE TO: West Virginia Secretary of State MAIL COMPLETED APPLICATION, ATTACHED ANNUAL REPORT, AND WEST VIRGINIA STATE TAX DEPARTMENT STATEMENT OF GOOD STANDING (NOT THE STATE TAX DEPARTMENT "REQUEST FOR STATEMENT OF GOOD STANDING" FORM GSR-01) WITH PAYMENT TO ONE OF THE BUSINESS CENTERS BELOW: READ INSTRUCTIONS BELOW CAREFULLY BEFORE SUBMITTING YOUR APPLICATION! Martinsburg Office Eastern Panhandle Business Center 229 E. Martin Street Martinsburg, WV 25401 Phone: TBA Fax: TBA Hours: Mon. - Fri. 9:00a - 5:00p EST Clarksburg Office North Central WV Business Center 200 West Main Street Clarksburg, WV 26301 Phone: (304) 367-2775 Fax: (304) 627-2243 Hours: Mon. -Fri. 9:00a - 5:00p EST Charleston Office One-Stop Business Center 1615 Washington Street East Charleston, WV 25311 Phone: (304) 558-8000 Fax: (304) 558-8381 Hours: Mon. - Fri. 8:30a - 5:00p EST CHOOSE ONE OF THE FOLLOWING PROCESSING SERVICES: 1 EXPEDITED SERVICE (24-hour, 2-hour and 1-hour; *Requires standard filing fee plus additional expedite fee, see below) West Virginia Secretary of State Business & Licensing Division Tel: (304) 558-8000 Fax: (304) 558-8381 Website: www.wvsos.gov Filing Submission Instructions - Business DivisionSUBMIT THE COMPLETED APPLICATION WITH THE CUSTOMER ORDER REQUEST FORM TO ONE OF THE OFFICES BELOW. CHOOSE EXPEDITED OR STANDARD PROCESSING SERVICE. IF NOT USING THE CUSTOMER ORDER REQUEST FORM AND YOU ARE REQUESTING EXPEDITED SERVICE,