DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
APPLICATION FOR REGISTRATION
OF FOREIGN LIMITED LIABILITY COMPANY
L025i
1.
Please read Instructions
ENTITY TYPE
–
check only one
to indicate the type of entity applying for registration:
LIMITED LIABILITY COMPANY PROFESSIONAL LIMITED LIABILITY COMPANY
2. NAME IN STATE OR COUNTRY OF FORMATION (FOREIGN NAME) –
enter the exact, true
name of the foreign LLC:
_____________________________________________________________________
3. NAME TO BE USED IN ARIZONA (ENTITY NAME) –
identify the name the foreign LLC will
use in Arizona by checking 3.1 or 3.2 (check only one), and follow instructions
:
3.1
Name in state or country of formation
, with no changes or additions – go to
number 4 and continue.
3.2
Fictitious name
– check this if the foreign LLC’s name in its state or country of
formation is not available for use in Arizona or if that name does not contain an LLC
identifier, and enter the name in number 3.3 below.
NOTE –
a resolution of the
company adopting the fictitious name must be attached to and submitted with this
form.
3.3 If you checked 3.2
, enter or print the name to be used in Arizona:
4. PROFESSIONAL LIMITED LIABILITY COMPANY SERVICES –
if professional LLC is checked
in number 1 above, describe the professional services that the professional LLC will provide
(examples: law firm, accounting, medical):
5. FOREIGN DOMICILE –
list the state or country in which the foreign LLC was formed:
______________________________________________________________________
6. DATE OF FORMATION IN FOREIGN DOMICILE:
____________________________________
7. PURPOSE OR GENERAL CHARACTER OF BUSINESS –
describe or state the purpose of the
foreign LLC or the general character of the business it proposes to transact in Arizona:
_____________________________________________________________________________
L025.001 Arizona Corporation Commission - Corporations Division
Rev: 2010 Page 1 of 3
______________________________________________________________