LLC-12 - Instructions (REV 08/2019)
2019 California Secretary of State
bizfile.sos.ca.gov
Instructions for Completing the
Statement of Information (Form LLC-12)
Every California and registered foreign limited liability company must file a Statement of Information with the
California Secretary of State, within 90 days of registering with the California Secretary of State, and every two
years thereafter during a specific 6-month filing period based on the original registration date, as described in the
chart below.
All Statements of Information for limited liability companies can be filed online at bizfile.sos.ca.gov.
Status of LLC: In order to file Form LLC-12, the status of the LLC must be active or suspended/forfeited on the
records of the California Secretary of State. The status of the LLC can be checked online on the Secretary of State’s
Business Search at BusinessSearch.sos.ca.gov. See the FTB Suspension/Forfeiture section below for information
about resolving an FTB suspended/forfeited status.
Fees: See chart below. Checks should be made payable to the Secretary of State.
Copies: To obtain a copy or certified copy of this filed Statement of Information, include payment for copy fees and
certification fees at the time this Statement of Information is submitted. Copy fees are $1.00 for the first page and
$.50 for each attachment page. For certified copies, there is an additional $5.00 certification fee, per document. If
you would like a free filed copy of your Statement of Information, go to BusinessSearch.sos.ca.gov.
Processing Time s: For current processing times, go to www.sos.ca.gov/business/be/processing-times.
Type of
Filing
Description Online/Form Fee
Initial Filing The initial filing is due 90 days from the
entitys registration date.
File online at bizfile.sos.ca.gov.
(Form LLC-12)
$20.00
Required
Periodic
Filing
The periodic filing is due every two
years based on the entitys
registration date.
If the registration occurred in an even-
numbered year, the periodic filing is
due every even year.
If the registration occurred in an odd-
numbered year, the periodic filing is
due every odd year.
The filing period includes the
registration month and the
immediately preceding five (5)
months.
File online at bizfile.sos.ca.gov.
(Form LLC-12, if changes have been
made)
Or
(Form LLC-12NC, if no changes since
the last complete Statement of
Information)
$20.00
No Fee
Statement
A Statement of Information is submitted
after the initial or required filing
requirements have been met to update
information including changes to the
agent for service of process.
File online at bizfile.sos.ca.gov.
(Form LLC-12)
No Fee
LLC-12 - Instructions (REV 08/2019)
2019 California Secretary of State
bizfile.sos.ca.gov
Statutory Required 6 Month Filing Window for Limited Liability Companies
Month of Formation,
Registration or Conversion
Statement of Information
Applicable Filing Period
First Day of
Through Last Day of
January August January
February September February
March October March
April November April
May December May
June
January
June
July
February
July
August March August
September April September
October May October
November June November
December July December
If you are not completing this form online, type or print legibly in black or blue ink. Complete the Statement of
Information (Form LLC-12) as follow s:
Item Instruction Tips
1. Enter the name of the limited liability
company exactly as it appears on file with
the California Secretary of State, including
the entity ending
(ex:Jones & Company, LLC” or “Smith
Construction, a Limited Liability
Company”).
To ensure you have the exact name of the LLC, refer to
your registration document filed with the California
Secretary of State and any name change amendments.
Some foreign LLCs may have registered in California using
an alternate name. If your LLC is a registered foreign LLC
using an alternate name in California, you must enter the
complete alternate name.
2. Enter the 12-digit Entity (File) Number
issued to the LLC by the California
Secretary of State at the time of
registration.
The 12-digit Entity (File) Number is provided by the
Secretary of State above the file stamp at the top of the
LLC’s registration document filed with the California
Secretary of State or if filed electronically, in the top section,
below the Entity Name.
Secretary of State Records can be accessed online through
our Business Search at BusinessSearch.sos.ca.gov. While
searching the Business Search, be sure to identify your LLC
correctly including the jurisdiction that matches your LLC.
3.
If formed outside of California, enter the
state, foreign country or other place where
the LLC is organized.
The jurisdiction must match the Secretary of State’s
records.
Secretary of State Records can be accessed online through
our Business Search at BusinessSearch.sos.ca.gov. While
searching the Business Search, be sure to identify your LLC
correctly including the jurisdiction that matches your
registered foreign LLC.
If the LLC is formed in California, leave Item 3 blank.
LLC-12 - I
nstructions (REV 08/2019)
2019 California Secretary of State
bizfile.sos.ca.gov
4a. Enter the complete street address, city,
state and zip code of the LLC’s principal
office.
The complete street address is required, including the
street name and number, city, state and zip code.
Address must be a physical address.
Do not enter a P.O. Box address, an “in care of” address, or
abbreviate the name of the city.
4b. If different from the address in Item 4a,
enter the complete mailing address, city,
state and zip code of the LLC.
This address will be used for mailing purposes and may be
a P.O. Box address or “in care of” an individual or entity.
Do not abbreviate the name of the city.
4c.
If the LLC is formed in California, enter
the complete street address, city and zip
code of the office in California, if different
from Item 4a.
If the LLC is formed outside of
California, enter the complete street
address, city and zip code of the principle
business office in California, if any.
The complete street address is required, including the
street name and number, city and zip code.
Address must be a physical address in California.
Do not enter a P.O. Box address, an “in care of” address, or
abbreviate the name of the city.
If Item 4a is an address in California leave Item 4c blank
and proceed to Item 5.
5.
Enter the name and complete business or
residential address of any manager(s),
appointed or elected in accordance with
the Articles of Organization or Operating
Agreement, or if no manager(s) has been
so elected or appointed, the name and
business or residential address of each
member.
If the LLC has more than one manager or member, enter
the name(s) and address(es) of the additional mangers or
members on Form LLC-12A.
Pl
ease do not abbreviate the name of the city.
Review your Articles of Organization or any amendments
thereto, to determine if the LLC is run by a single manager,
more than one manager or by its member(s).
Every LLC is required to have at least one
manager/member.
A member(s) is the owner of the LLC similar to a
shareholder(s) in a corporation.
6.
The LLC must have an Agent for Service
of Proce ss.
There are two types of Agents that can be
named:
an individual (e.g. member, manager, or
any other individual) who resides in
California with a physical California street
address; OR
a registered corporate agent qualified
with the California Secretary of State.
An Agent for Service of Process is responsible for accepting
legal documents (e.g. service of process, lawsuits,
subpoenas, other types of legal notices, etc.) on behalf of
the LLC.
You must provide information for either an individual OR a
registered corporate agent, not both.
If using a registered corporate agent, the corporation must
have a current agent registration certificate on file with the
California Secretary of State as required by Section 1505.
6a & b.
If Individual Agent:
Enter the name of the agent for service of
process and the agent’s complete
California street address, city and zip
code.
If an individual is designated as the
agent, complete Items 6a and 6b ONLY.
Do not complete Item 6c.
The complete street address is required, including the
street name and number, city and zip code.
Do not enter a P.O. Box address, an “in care of” address, or
abbreviate the name of the city.
Many times, a small LLC will designate a member or
manager as the agent for service of process.
The individual agent should be aware that the name and the
physical street address of the agent for service of process is
a public record, open to all (as are all the addresses of the
LLC provided in filings).
LLC-12 - Instructions (REV 08/2019)
2019 California Secretary of State
bizfile.sos.ca.gov
6c. If Registered Corporate Agent:
Enter the name of the registered
corporate agent exactly as registered in
California.
If a registered corporate agent is
designated as the agent, complete Item
6c ONLY. Do not complete Items 6a
and 6b.
Before a corporation is designated as agent for the LLC,
that corporation must have a current agent registration
certificate on file with the California Secretary of State as
required by Section 1505 stating the address(es) of the
registered corporate agent and the authorized employees
that will accept service of process of legal documents and
notices on behalf of the LLC.
Advanced approval must be obtained from a registered
corporate agent prior to designating that corporation as
your agent for service of process.
No California or foreign corporation may register as a
California corporate agent unless the corporation currently
is authorized to engage in business in California and is in
good standing on the records of the California Secretary of
State.
Provide your Registered Corporate Agents exact name as
registered with the California Secretary of State. To
confirm that you are providing the exact name of the
Registered Corporate Agent, go to
https://businessfilings.sos.ca.gov/frmlist1505s.asp.
7. Briefly describe the general type of
business that is the principal business
activity of the LLC.
8. Enter the name and complete business or
residential address of the chief executive
officer, if any.
A chief executive officer may be in addition to members and
managers but generally is the person that occupies the
highest level position in the LLC’s organization hierarchy in
charge of managing the LLC.
9.
Type or print the date, the name and title of
the person completing this form and sign
where indicated.
Mail Submission Cover Sheet (Optional): To make it easier to receive communication related to this document,
including the copy of the filed document, complete the Mail Submission Cover Sheet. For the Return Address: enter
the name of a designated person and/or company and the corresponding mailing address. Please note the Mail
Submission Cover Sheet will be treated as correspondence and will not be made part of the filed document.
Where to File: For faster service, this form can be filed online at bizfile.sos.ca.gov. The completed form along with
the applicable fees can be mailed to Secretary of State, Statement of Information Unit, P.O. Box 944230, Sacramento,
CA 94244-2300 or delivered in person (drop off) to the Sacramento office, 1500 11th Street, Sacramento, CA 95814.
Legal Authority: General statutory filing provisions are found in Section 17702.09 unless otherwise indicated. All
statutory references are to the California Corporations Code, unless otherwise stated. Failure to file this Statement of
Information by the due date will result in the assessment of a $250.00 penalty. (Sections 17713.07(b) and 17713.09;
California Revenue and Taxation Code section 19141.)
FTB Suspension/Forfeiture: If the LLC’s status is FTB suspended/forfeited, the status must be resolved with the
California Franchise Tax Board (FTB) for the LLC to be returned to active status. For revivor requirements, go to the
FTBs website at https://www.ftb.ca.gov or contact the FTB at (800) 852-5711 (from within the U.S.) or (916) 845-6500
(from outside the U.S.).
Secretary of State
Business Programs Division
Statement of Information, P.O. Box 944230, Sacramento, CA 94244-2300
Mail Submission Cover Sheet
Instructions:
Complete and include this form with your submission. This information only will be used to communicate with you
in writing about the submission. This form will be treated as correspondence and will not be made part of the filed
document.
Make all checks or money orders payable to the Secretary of State.
Standard processing time for submissions to this office is approximately 5 business days from receipt. All
submissions are reviewed in the date order of receipt. For updated processing time information, go to
www.sos.ca.gov/business/be/processing-times.
Optional Copy and Certification Fees:
If applicable, include optional copy and certification fees with your submission.
For applicable copy and certification fee information, refer to the instructions of the specific form you are submitting.
Entity Information: (Please type or print legibly)
Name: __________________________________________________________________________________________________________________
Entity Number (if applicable): _____________________________________
Comments: _____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Return Address: For written communication from the Secretary of State related to this document, or if purchasing a
copy of the filed document enter the name of a person or company and the mailing address.
Name:
Company:
Address:
City/State/Zip:
Secretary of State Use Only
T/TR:
AMT REC’D: $
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Date
LLC-12 (REV 08/2019)
2019 California Secretary of State
bizf
ile.sos.ca.gov
Secretary of State
Statement of Information
(Limited Liability Company)
LLC-12
IMPORTANT — This form can be filed online at bizfile.sos.ca.gov.
Read instructions before completing this form.
Filing
Fee – $20.00
Copy Fees First page $1.00; each attachment page $0.50;
Certification Fee - $5.00 plus copy fees
Above Space For Office Use Only
1. Limited Liability Company Name (Enter the exact name of the LLC. If you registered in California using an alternate name, see instructions.)
2. 12-Digit Secretary of State Entity (File) Number 3. State, Foreign Country or Place of Organization (only if formed outside of California)
4. Business Addresses
a. Street Address of Principal Office - Do not list a P.O. Box City (no abbreviations) State Zip Code
b. Mailing Address of LLC, if different than item 4a
City (no abbreviations) State Zip Code
c. Street Address of California Office, if Item 4a is not in California - Do not list a P.O. Box
City (no abbreviations) State
CA
Zip Code
5. Manager(s) or Member(s)
If no managers have been appointed or elected, provide the name and address of each member. At least one name and address
must be listed. If the manager/member is an individual, complete Items 5a and 5c (leave Item 5b blank). If the manager/member is
an entity, complete Items 5b and 5c (leave Item 5a blank). Note: The LLC cannot serve as its own manager or member. If the LLC
has additional managers/members, enter the name(s) and address(es) on Form LLC-12A.
a. First Name, if an individual - Do not complete Item 5b Middle Name Last Name Suffix
b. Entity Name - Do not complete Item 5a
c. Address City (no abbreviations) State Zip Code
6. Service of Process (Must provide either Individual OR Corporation.)
INDIVIDUAL – Complete Items 6a and 6b only. Must include agent’s full name and California street address.
a. California Agent's First Name (if agent is not a corporation)
Middle Name Last Name Suffix
b. Street Address (if agent is not a corporation) - Do not enter a P.O. Box
City (no abbreviations) State
CA
Zip Code
CORPORATION – Complete Item 6c only. Only include the name of the registered agent Corporation.
c. California Registered Corporate Agent’s Name (if agent is a corporation) – Do not complete Item 6a or 6b
7. Type of Business
Describe the type of business or services of the Limited Liability Company
8. Chief Executive Officer, if elected or appointed
a. First Name Middle Name Last Name Suffix
b. Address City (no abbreviations) State Zip Code
9. By signing, I affirm under penalty of perjury that the information herein is true and correct and that I am authorized by California law to sign.
_____________________ ____________________________________________________________ ________________________ __________________________________
Type or Print Name of Person Completing the Form Title Signature
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