Foreignllcnameregistration Feb 2018
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
corpinfo@state.sd.us
Pursuant to the provisions of South Dakota law, the undersigned Limited Liability Company hereby applies for
the registration of its name to and including December 31, , and submits the following:
1. The name of the company:
2. The name of the state or other jurisdiction under whose laws it is organized:
3. The date of its organization:
4. The business in which it is engaged:
5. This application is
accompanied by an original Certificate of Existence executed by the Secretary of
State or other official having custody of the organizational records in the state or other jurisdiction under whose
law it is organized.
6.
This application does not qualify the LLC to conduct business in South Dakota.
The regi
stration is effective until the close of the calendar year in which the application for registration is filed.
A renew
al application may be filed between the first day of October and the thirty-first day of December each year, and shall
extend the registration for the following calendar year.
No pers
on 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
Title
APPLICATION FOR
REGISTRATION OF NAME
FOREIGN LIMITED LIABILITY COMPANY
SDCL 47-34A-107, 1005
FILING FEE: $25
Make check payable to SECRETARY OF STATE
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