Fill - Instructions for Completing the Statement of Information (Form (California)

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

entity’s 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 entity’s

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)

(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.

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.

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.

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 Agent’s 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.

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

FTB’s 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: $

Doc Submission Cover - SI (Est. 11/2016)

Clear Form

Print Form

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

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

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.

_____________________ ____________________________________________________________ ________________________ __________________________________

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