Application For Registration Of Foreign Limited Liability Company {LL0005}

ARIZONA CORPORATION COMMISSION FOREIGN LIMITED LIABILITY COMPANY FILING CHECKLIST See A.R.S. 29-601 et seq.Company Name Check name for availability using the preliminary name search instructions on our web site at www.cc.state.az.us/corp/filings/namesrch.htm Attach copy of Trade name Certificate, Assignment if applicable, or attach completed Declaration of Tradename Holder. Make sure company name has the appropriate corporate ending pursuant A.R.S. 29-602.A. and 29- 804. Attach resolution adopting fictitious name. Must be approved and signed by a manager if management is vested in managers or by members if management is reserved to members.Application for Registration Indicate the exact name of the foreign limited liability company. Indicate the fictitious name adopted for use in Arizona, if the exact name is not available. Indicate the state, province or country in which the company is formed. Indicate the date of formation. Indicate the purpose of the company or the general character of business the company proposes to transact in Arizona. Indicate the name and address of the statutory agent in Arizona. If statutory agent has P.O. Box, then they must also provide a street address/location. Indicate if management is reserved to the members or vested in a manager(s). < If reserved to the members, indicate the name(s) and address(es) of the members. < If vested in a manager, indicate the name(s) and address(es) of the manager(s) AND the member(s) tho own 20% or greater interest in the capital or profits of the company. Indicate the address of the office required to be maintained in the jurisdiction under the laws of which the company is organized, if required; or, if not required, then the address of the principal office of the company. Affix a signature. The document must be signed by a manager, member, or authorized agent. Affix signature of statutory agent (acknowledge acceptance).Fees Attach check for filing fee. $150.00. Additional $35.00 for expedited services. Made Payable to the Arizona Corporation Commission. Execute check. Fees pursuant to A.R.S. 29-851. Publication Publication is not required Copies Attach a certificate of existence or document of similar import duly authenticated (within sixty (60) days) by the official having custody of corporate records in the state, province or county under whose laws the corporation in incorporated (AZ Const. Art. XIV,8). 1300 WEST WASHINGTON, PHOENIX, ARIZONA 85007-2929 / 400 WEST CONGRESS STREET, TUCSON, ARIZONA 85701-1347 www.cc.state.az.us - 602-542-3135<<<<<<<<<********>>>>>>>>>>>>> 2DO NOT PUBLISH THIS SECTION 1. The company name must contain an ending which APPLICATION FOR REGISTRATIONmay be limited liability OF A FOREIGN LIMITED LIABILITY COMPANYcompany, limited company, or the 1. The name of the foreign limited liability company is:abbreviations L.L.C., L.C., LLC or LC. If you are the holder or assignee of a tradename or trademark, attach 1.a. If the exact name of the foreign limited liability company is not available for use inDeclaration of this state, then the fictitious name adopted for use by the limited liability company inTradename Holder form. If your Arizona is: name is not available for use in Arizona, you (FN) must adopt a fictitious name and provide a resolution 2. The company is organized under the laws of: adopting the name, (State)which must be signed by a manager, member or 3. The date of the companys formation is: authorized agent. 2. Provide the 4. The purpose of the company or the general character of business it proposes to transactname of the state in Arizona is: or jurisdiction under whose laws your company was formed. 3. Provide the date on which your company organized 5. The name and street address of the statutory agent for the foreign limited liabilityin the state or jurisdiction under company in Arizona is: whose laws it was formed. 4. Provide the general character of business you ACCEPTANCE OF APPOINTMENT BY STATUTORY AGENTplan to transact in Arizona. 5. The statutory agent must provide I, , having been designated to act as statutorya street address. (Print Name)If statutory agent has a P.O. Box, agent, hereby consent to act in that capacity until removed or resignation is submitted in then they must accordance with the Arizona Revised Statutes.also provide a street address/location. The agent must consent to the [Signature] appointment by executing the consent. pany serving as [If signing on behalf of a company serving as <<<<<<<<<********>>>>>>>>>>>>> 36 . Check which 6. Management management structure will G Management of the limited liability companyvested in a manager or is be applicable managers. The names and addresses of each person who is a manager AND to your company. Provide name, each member who owns a twenty percent or greater interest in the capital or title and address profits of the limited liability company are: for each person. Name: [ ] member [ ] manager [ ] member [ ] manager Address: City, State, Zip: Attach a certificate of existence or [ ] member [ ] manager [ ] member [ ] manager document of similar import duly authenticated (within sixty (60) days)by the official having custody of corporate G Management of the limited liability companyreserved to the members is . records in the The names and addresses of each person who is a member are: state, province or county under whose laws the corporation is incorporated (AZ Const. Art. [ ] member [ ] member XIV, 8). Your fax and phone number is optional. 7. If the [ ] member [ ] member jurisdiction under the law of which your company is formed, you must provide the address of the principle office PHONE FAX of the company, in whatever state or jurisdiction 7. The address of the office required to be maed in the jurisdiction under the laws of intainit is located. which the company is organized, if required; or, if not required, the address of the principal office of the company is: The application must be signed by a member, manager or duly authorized agent. Executed this day of , .See A.R.S. 29-601 et seq. for more [Signature] info. LL0005 [Print Name] (Check One) G Member G Manager G Authorized Agent Rev. 09/04