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Washington LLC - Formation Washington Secretary of State Revised 03/16
Page 1 of 2
Limited Liability Company
See attached detailed instructions
□ Filing Fee $180.00
□ Filing Fee with Expedited Service $230.00
CERTIFICATE OF FORMATION
Chapter 25.15 RCW
SECTION 1
NAME OF LIMITED LIABILITY COMPANY:
____________________________________________________________________________
(Must contain one of the following designations: Limited Liability Company, Limited Liability Co or one of these
abbreviations: L.L.C. or LLC. If the designation is omitted, it will default to LLC when processed)
SECTION 2
ADDRESS OF THE PRINCIPAL OFFICE:
Street Address ______________________________City State ____Zip__________
PO Box ____________________________________City___ __________State ____Zip__________
SECTION 3
EFFECTIVE DATE OF FORMATION: (Please check one of the following)
□ Upon filing by the Secretary of State
□ Specific Date: __________________ (Specified effective date must be within 90 days AFTER the Certificate
of Formation has been filed by the Office of the Secretary of State)
SECTION 4
TENURE: (Please check one of the following and indicate the date if applicable)
□ Perpetual existence
□ Specific term of existence _______________ (Number of years or date of termination)
This Box For Office Use Only
UBI Number:
Washington LLC - Formation Washington Secretary of State Revised 03/16
Page 2 of 2
SECTION 5
DESIGNATION OF REGISTERED AGENT: COMPLETE ITEM 1, 2, OR 3
1. If using a Commercial Registered Agent (as defined in RCW 23.95.105(3))
Yes: □ If yes, complete this section and then proceed to Consent of Registered Agent below.
No: □ If no, skip to item 2 below.
Name of Commercial Registered Agent:
2. If using a Noncommercial Registered Agent (as defined in RCW 23.95.105(21))
Yes: □ If yes, complete this section and then proceed to Consent of Registered Agent below.
No: □ If no, skip to item 3 below.
Name of Noncommercial Registered Agent:
Physical Address in WA:
Alternate Mailing Address in WA:
3. If using an Office or Position in the entity to serve as agent (as defined in RCW 23.95.105(21)(b))
Yes: □ If yes, complete this section and then proceed to Consent of Registered Agent below.
Office or Position service as Agent:
Physical Address in WA:
Alternate Mailing Address in WA:
CONSENT SIGNATURE REQUIRED IN ADDITION TO COMPLETING ITEM 1, 2, or 3 ABOVE (RCW 23.95.415(2))
I hereby consent to serve as Registered Agent in the State of Washington for the above named entity. I understand it will
be my responsibility to accept service of process, notices, and demands on behalf of the entity; to forward mail to the
entity; and to immediately notify the Office of the Secretary of State if I resign or change the Registered Office Address.
X_______________________________________________________________________________________
Signature of Registered Agent Printed Name Date Phone
SECTION 6
NAME, ADDRESS AND SIGNATURE OF EACH EXECUTOR:
(If necessary, attach additional names, addresses and signatures)
Name: __________________________________________________________________________________
Address: _______________________________City ___________________State _Zip Code_______
This document is hereby executed under penalties of perjury, and is, to the best of my knowledge, true and correct.
X_______________________________________________________________________________________
Signature of Executor Printed Name Date Phone
Washington LLC - Formation Washington Secretary of State Revised 03/16
INSTRUCTIONS - CERTIFICATE OF FORMATION
Please complete all sections of the Certificate of Formation. USE DARK INK ONLY. For an electronic, fillable
version of this form, please visit our website at www.sos.wa.gov/corps
SECTION 1:
Enter the name of the Limited Liability Company (LLC). In accordance with RCW 23.95 a LLC name must contain the
words Limited Liability Company, the words Limited Liability Co., or the abbreviation L.L.C. or LLC. A Limited Liability
Company name must be distinguishable upon the records of the Secretary of State from any other formally organized
entity registered with the Secretary of State’s office. If the designation is omitted, it will default to LLC when processed.
SECTION 2:
Enter the address of the Limited Liability Company’s principle office. This is the location where business records are kept.
SECTION 3:
Choose either upon filing by the Secretary of State or you may indicate an effective date. The effective date can be up to
90 days AFTER filing of the Certificate of Formation by the Office of the Secretary of State.
SECTION 4:
Perpetual (i.e. ongoing until dissolved) or list a specific date or a specific number of years.
SECTION 5:
All entities must have a registered agent in Washington State RCW 23.95.415. The Designation of Registered Agent is
used to select the type of agent such as a Commercial Registered Agent, a Noncommercial Registered Agent, or and
Office or Position serving as Registered Agent. The Consent of Registered Agent must be signed in addition to the name
and address provided.
SECTION 6:
The Executor is the person(s) forming the Limited Liability Company. Please list the full name and address of each
Executor. All Executors must sign the Certificate of Formation. Attach an additional list if necessary.
ADDITIONAL INFORMATION:
You may attach any optional provisions to this certificate (please do not attach operating agreements or meeting minutes,
these items are not filed with this office).
FEES: The filing fee for the Certificate of Formation is $180.00 If expedited service is requested then include an
additional $50.00 and write “EXPEDITE” on the outside of the envelope. Make the checks or money orders payable to
“Secretary of State”. (ALL fees are non-refundable and all documents are public record)
Mail completed forms and payment to:
In Person:
By Mail:
Secretary of State
Secretary of State
Corporations Division
Corporations Division
801 Capitol Way S
PO BOX 40234
Olympia, WA 98501-1226
Olympia, WA 98504-0234
If you have questions, need assistance, or would like to provide feedback please visit the Corporations Division
website at www.sos.wa.gov/corps, call 360-725-0377 or email corps@sos.wa.gov
.
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Filing Fee $180.00 Filing Fee with Expedited Service (How to Start a Business)

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Completed 20 November 2020

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