NCSB Form PLLC-1
Revised May 2015
3. The jurisdictions other than North Carolina in which the PLLC will maintain an office are
Name of Jurisdiction Address of Office(s)
4. The undersigned represent that the PLLC will be conducted in compliance with The North Carolina Limited
Liability Company Act and with the North Carolina State Bar’s Regulations for Professional Corporations
and Professional Limited Liability Companies Practicing Law. (27 N.C.A.C. 1E, Section .0100)
5. Application is hereby made for a Certificate of Registration to be effective upon the effective date of the
PLLC’s articles of organization after said articles are filed with the Secretary of State.
6. Attached hereto is the registration fee of fifty dollars ($50).
This the ________ day of __________________, 20 ______.
(Signature of all persons executing
the articles of organization)
I hereby certify that ________________________, ________________________,
________________________, and ________________________, being all of the persons executing the articles of
organization of ________________________________________________________, a professional limited liability
company, personally appeared before me this day and stated that they have read the foregoing Application for
Certificate of Registration for a Professional Limited Liability Company and that the statements contained therein are
Witness my hand and notarial seal, this ________ day of ___________________,
My commission expires: ____________________
If the PLLC will maintain an office in another jurisdiction, contact the State Bar Membership Department (919-828-4620)
to determine whether the PLLC must also register as an Interstate Law Firm.