Fillable Ma Pllc Annual (How to Start a Business)

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Ma Pllc Annual (How to Start a Business)

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The Commonwealth of Massachusetts
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512
Professional Limited Liability Company Annual Report
(General Laws Chapter 156C, Section 12)
_____________________________ Year: ____________________
Federal Identification No.:
(1a) e exact name of the limited liability company:
________________________________________________________________________________________________
(1b) e exact name of the limited liability company as amended:
________________________________________________________________________________________________
(2) e street address of the office in the commonwealth at which its records will be maintained:
(3a) e professional service to be rendered:
________________________________________________________________________________________________
(3b) e name and address of each member or manager who will render a professional service in the Commonwealth:
(3c) e limited liability company agrees that each member or manager who will render a service in the Commonwealth is duly
licensed to provide the service and to abide by and be subject to any conditions or limitations established by any applicable regu-
lating board including the provision of liability insurance required by M.G.L. c.156C § 65.
___________________________________________________________________
(4) Latest date of dissolution, if specified:
(5) e name and street address of the resident agent in the commonwealth:
P
(6) e name and business address of each manager, if any, and if none, so state:
Corporations Division, and at least one person shall be named if there are no managers:
(7) e name and business address of the person(s) in addition to manager(s) authorized to execute documents filed with the
instrument purporting to affect an interest in real property.
(8) e name and business address of the person(s) authorized to execute, acknowledge, deliver and record any recordable
(9) Additional matters:
________________________________________________________________ Signed by (by at least one authorized signatory):
COMMONWEALTH OF MASSACHUSETTS
William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
Professional Limited Liability Company Annual Report
(General Laws Chapter 156C, Section 12)
-
tion; and the filing fee in the amount of $ ___ having been paid, said application
I hereby certify that upon examination of this professional limited liability company
annual report, duly submitted to me, it appears that the provisions of the General
Laws relative thereto have been complied with, and I hereby approve said applica
is deemed to have been filed with me this
________________ day of ________________, 20 _____, at _______a.m./p.m.
time
WILLIAM FRANCIS GALVIN
Secretary of the Commonwealth
Filing fee: $500
TO BE FILLED IN BY LIMITED LIABILITY COMPANY
Contact Information:
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________
Telephone:
______________________________________________________Email:
Upon filing, a copy of this filing will be available at www.sec.state.ma.us/cor.
If the document is rejected, a copy of the rejection sheet and rejected document will
be available in the rejected queue.
c156cs12pllcannual 10/14/08
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Completed 16 July 2020

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