COVER LETTER
TO: Registration Section
Division of Corporations
SUBJECT:
Name of Limited Liability Company
Dear Sir or Madam:
The enclosed Statement of Correction and fee(s) are submitted for filing.
Please return all correspondence concerning this matter to the following:
Name of Person
Firm/Company
Address
City/State and Zip Code
E-mail address: (to be used for future annual report notification)
For further information concerning this matter, please call:
at ( )
Name of Person Area Code Daytime Telephone Number
Mailing Address: Street Address:
Registration Section Registration Section
Division of Corporations Division of Corporations
P.O. Box 6327 The Centre of Tallahassee
Tallahassee, FL 32314 2415 N. Monroe Street, Suite 810
Tallahassee, FL 32303
Enclosed is a check for the following amount:
$25 Filing Fee $30 Filing Fee & $55 Filing Fee & $60 Filing Fee,
Certificate of Status Certified Copy Certificate of Status &
Certified Copy
CR2E062 (9/15)
STATEMENT OF CORRECTION
FOR
FLORIDA OR FOREIGN LIMITED LIABILITY COMPANY
Pursuant to section 605.0209, F.S., this document is being submitted to correct a previously filed document.
FIRST: The name of the limited liability company is:
SECOND: The Florida Document number of the limited liability company is:
THIRD: Document to be corrected is:
(CHECK THE APPROPRIATE BOX AND COMPLETE THE APPLICABLE STATEMENT
Contains an incorrect statement. The incorrect statement, the reason the statement is incorrect, and the corrected
statement are as follows:
OR
Was defectively signed. The manner in which the document was defectively signed and the appropriate correction are
as follows:
OR
The electronic transmission of the record was defective.
Signature of Authorized Representative Date
Signature of new registered agent, if applicable :( NOTE: if correcting the registered agent, the new registered agent must sign
accepting the designation).
New Registered Agent’s Signature, if changing Registered Agent:
I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the
provisions of all statutes relative to the proper and complete performance of my duties, and I am familiar with and accept the
obligations of my position as registered agent as provided for in Chapter 605, F.S. Or, if this document is being filed to merely
reflect a change in the registered office address, I hereby confirm that the limited liability company has been notified in writing
of this change.
Registered Agent’s Signature
Filing Fee: $25.00
Certified Copy: $30.00 (optional)
CR2E062 (9/15)