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Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
Enter Filing Year
1. Business ID and Name:
Business ID
Business Name
2. The jurisdiction under whose law it is formed
3. The address of the principal executive office (business address).
Actual Street Address City State ZIP+4
Mailing Address, if Different from Street Address City State ZIP+4
Email Address (Optional)
4.
The South 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
) When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from t
he
C
ommercial Registered Agent.
Commercial Registered Agent Name CRA#
ANNUAL REPORT
FOREIGN LIMITED LIABILITY COMPANY
SDCL 47-34A-211; 59-11-24, 24.1
FILING
FEE: $65
Additional Fee for Delinquent Reports: $50
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Annualreportforeignllc Feb 2018
5. If the LLC is manager-managed, list the names and addresses of its manager(s). SDCL 59-11-24. If the LLC is member-
managed, this section may be left blank.
Manager/Governor Actual Street Address City State ZIP+4
Manager/Governor Actual Street Address City State ZIP+4
Manager/Governor Actual Street Address City State ZIP+4
6. Beneficial Interest (optional)
Owner Description of Ownership Percentage/Value
Owner Description of Ownership Percentage/Value
No per
son 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).
Dated
Signature of an authorized person
Email
(Optional) Printed Name
click to sign
signature
click to edit