DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY.
MEMBER STRUCTURE ATTACHMENT
1. ENTITY NAME – give the exact name of the LLC (foreign LLCs – give name in domicile state or country):
______________________________________________________________________
2. A.C.C. FILE NUMBER (if known):
__________________________________________________
Find the A.C.C. file number on the upper corner of filed documents OR on our website at: http://www.azcc.gov/Divisions/Corporations
3. MEMBERS – give the name and address of all Members. If more space is needed, use another Member Structure
Attachment form.
Name Name
Address 1 Address 1
Address 2 (optional) Address 2 (optional)
City
Country
State or
Province
Zip City
Country
State or
Province
Zip
Name Name
Address 1 Address 1
Address 2 (optional) Address 2 (optional)
City
Country
State or
Province
Zip City
Country
State or
Province
Zip
Name Name
Address 1 Address 1
Address 2 (optional) Address 2 (optional)
City
Country
State or
Province
Zip City
Country
State or
Province
Zip
L041.002 Arizona Corporation Commission – Corporations Division
Rev: 2014 Page 1 of 1
Name Name
Address 1 Address 1
Address 2 (optional) Address 2 (optional)
City
Country
State or
Province
Zip City
Country
State or
Province
Zip
1.
2.
3.
4.
5.
6.
7.
8.
