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Page 1 of 2
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
1. The Nam
e and Business ID of the company is:
Name (Note: This must be the exact limited liability company name as registered.)
2. The nam
e of the state or other jurisdiction under whose laws it is organized:
Business ID
South
Dakota
3.
The S
outh Dakota Registered Agent’s name
South Dakota law permits the registered agent to be either: A) noncommercial registered agent (this may be an
individual) or B) a commercial registered agent. Complete only one below, either (a) or (b).
(a) The South Dakota Noncommercial Registered Agent’s name
Actual Street Address in this State City State ZIP+4
Mailing Address in this State, if Different from Street Address City State ZIP+4
_____________________________________________________________________________________________________________________
Email Address (Optional)
(b) W
hen listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from the
Commercial Registered Agent.
Commercial Registered Agent Name CRA#
4. Lis
t the acreage and location by section, township and county of each lot or parcel of land in this state owned or leased
by the Limited Liability Company and used for the growing of crops or the keeping or feeding of poultry or livestock (You
may add additional pages if necessary).
Acres Section Township County
Acres Section Township County
Acres Section Township County
Acres Section Township County
5. Is the majority of the voting stock held by members of a family, an estate of a family member, or a trust that benefits
members of the family?
Yes No
QUALIFICATION FOR FARMING
DOMESTIC LIMITED LIABILITY COMPANY
SDCL 47-9A
Pl
ease Type or Print Clearly in Ink
NO FILING FEE
Page 2 of 2
Domesticllcfarmqualification March 2017
6. Is at least one of the stockholders:
(a) a person residing on the farm? Yes No
(b) a person actively operating the farm? Yes No
(c) a person who has resided on the farm? Yes No
(d) a person who has actively operated the farm? Yes No
7. State the number of shares owned by persons residing on the farm or actively engaged in farming or their relatives within
the third degree of kindred (You may add additional pages if necessary).
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
8. Are all the shareholders either natural persons, estates of a family member, or a trust that benefits members of the
family?
Yes No
9. The percentage of gross receipts of the Limited Liability Company derived from rent, royalties, dividends, interest, and
annuities:
_____%
10. State the number of shareholders. _____
11. Is there more than one class of stock? Yes No
12. As to each shareholder state the name, address, number of shares owned, and degree of kindred (DOK).
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
Name Address City State Zip Shares DOK
No person may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal
penalty (SDCL 22-39-36).
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Completed 3 July 2020

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