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OF APPLICATION FOR AUTHORITY (New York State)

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Page 1 of 3
DOS-1361-f-a (Rev. 03/17)
Department of State
DIVISION OF CORPORATIONS,
STATE RECORDS AND
UNIFORM COMMERCIAL CODE
One Commerce Plaza
99 Washington Ave.
Albany, NY 12231-0001
www.dos.ny.gov
APPLICATION FOR AUTHORITY
OF
(Insert name of Foreign Limited Liability Company)
Under Section 802 of the Limited Liability Company Law
FIRST: The name of the foreign limited liability company is:
.
If the name does not contain the required words or abbreviation pursuant to Section 204 of the Limited
Liability Company Law, the following words or abbreviation is added to the name for use in this state:
.
(Do not complete this section unless the foreign limited liability company’s true name is not available pursuant to §204 of the
Limited Liability Company Law.)
The fictitious name under which the foreign limited liability company will do
business in New York is:
.
(The fictitious name must contain the words "Limited Liability Company" or abbreviation "LLC" or "L.L.C.")
SECOND: The jurisdiction of organization of the foreign limited liability company is:
.
The date of its organization is: .
THIRD:
The county within New York state in which the office, or if more than one office, the principal
office of the foreign limited liability company is to be located is: .
(A county in New York is required. Please note that the limited liability company is not required to have an actual physical
office in this state.)
FOURTH: The Secretary of State is designated as agent of the foreign limited liability company upon
whom process against it may be served. The address within or without this state to which the Secretary of
State shall mail a copy of any process served against him or her is:
.
Page 2 of 3
DOS-1361-f-a (Rev. 03/17)
FIFTH: (Check and complete the statement that applies)
The address of the office required to be maintained in the jurisdiction of its formation is:
.
No office is required to be maintained in the jurisdiction of its formation. The address of the principal
office of the foreign limited liability company is:
.
SIXTH:
The foreign limited liability company is in existence in its jurisdiction of formation at
the time
of filing of this application.
SEVENTH:
The authorized officer (e.g. "Secretary of State") in its jurisdiction of its formation where a
copy of its articles of organization is filed is:
.
The address of the authorized officer is:
.
X
(Signature)
(Type or print name)
Capacity of signer (Check appropriate box):
Member
Manager
Authorized Person
Page 3 of 3
DOS-1361-f-a (Rev. 03/17)
APPLICATION FOR AUTHORITY
OF
(Insert name of Foreign Limited Liability Company)
Under Section 802 of the Limited Liability Company Law
Filer’s Name and Mailing Address:
Name:
Company, if Applicable:
Mailing Address:
City, State and Zip Code:
NOTES:
1. This form was prepared by the New York State Department of State for filing an application for authority for a
foreign limited liability company to conduct business in New York State. It does not contain all optional provisions
under the law. You are not required to use this form. You may draft your own form or use forms available at legal
supply stores.
2. Attach a Certificate of Existence, Certificate of Good Standing or Certificate of Status from the official who files
and maintains limited liability company records in the jurisdiction of the foreign limited liability company’s
formation.
3. The name of the foreign limited liability company and its date of formation provided on this document must exactly
match the name of the foreign limited liability company and, if applicable, the date of formation stated in the
Certificate of Existence, Certificate of Good Standing or Certificate of Status.
4. The Department of State recommends that legal documents be prepared under the guidance of an attorney.
5. The application for authority must be submitted with a $250 filing fee made payable to the Department of State.
(For office use only.)
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Completed 20 January 2021

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