BUSINESS REGISTRATION DIVISION
P.O. BOX 29622
RALEIGH, NC 27626-0622
(Revised July 2017) (Form L-09)
Instructions for Filing
APPLICATION FOR CERTIFICATE OF AUTHORITY FOR A LIMITED LIABILITY COMPANY
Item 1 Enter the complete name of the limited liability company (LLC) exactly as it appears in the records of the
appropriate official in the state or country of formation. If the name cannot be used in North Carolina,
enter the name (including an applicable limited liability company ending) that it wishes to use in North
Item 2 Enter the state or country of formation.
Item 3 Select item “a” if the LLC has a principal office. Enter the complete street address of the principal office
and the county in which it is located. If mail is not delivered to the street address of the principal office or
if you prefer to receive mail at a P.O. Box or Drawer, enter the complete mailing address of the principal
Select item “b” if the LLC does not have a principal office.
Item 4 Enter the name of the registered agent. The registered agent must be a North Carolina resident, an
existing domestic business corporation, nonprofit corporation or limited liability company, or a foreign
business corporation, nonprofit corporation or limited liability company authorized to transact business or
conduct affairs in North Carolina.
Item 5 Enter the complete street address of the LLC’s registered office and the county in which it is located. The
registered office address must be located in North Carolina.
Item 6 Enter the complete mailing address, in North Carolina, of the LLC’s registered agent, only if mail is not
delivered to the street address above or if you prefer to receive mail at a P.O. Box or Drawer.
Item 7 Enter the names, titles, and usual business address of the current principal company officials of the LLC.
Item 8 Attach a current Certificate of Existence or document of similar import with filing.
Item 9 If needed, a statement indicating a copy of the resolution of its managers adopting a fictitious name is
Item 10 The Department offers a free voluntary notification system for which you may choose to participate. If
you would like to receive this free service, please provide a business e-mail address in the space provided.
Your participation will not result in your e-mail address being viewable on our website. Participation will
help us to prevent identity theft in the event an unauthorized person submits a fraudulent document for
filing in the name of the business entity.
Item 11 The document will be effective on the date and at the time of filing, unless a delayed date or an effective
time (on the date of filing) is specified. If a delayed effective date is specified without a time, it will be
effective at 11:59:59 p.m. A delayed effective date may be specified up to and including the 90
after the day of filing.
Date and Execution
Enter the date the document was executed.
In the blanks provided enter:
The name of the limited liability company as it appears in Item 1.
The signature of the principal company official of the LLC executing the document.
The name and title of the above-signed principal company official.
Attention: Foreign Limited Liability Companies wishing to render a professional service as defined in N.C.G.S.
§55B-2(6) shall contact the appropriate North Carolina licensing board to determine whether compliance with
additional licensing requirements may be mandated by law. Such limited liability companies should consult
N.C.G.S. §57D-2-02 for further details.