LLC Cert of Formation - 01/2021 Page 1 of 2
PURPOSE: In order to form a Limited Liability Company (LLC) under Section 10A-5A-2.01 of the Code of Alabama
1975 this Certificate of Formation and the appropriate filing fees must be filed with the Office of the Secretary of State.
The information required in this form is required by Title 10A.
INSTRUCTIONS: Mail one (1) signed original and one (1) copy of this completed form along with a self-addressed,
stamped envelope with the filing fee of $200.00 (credit card, check, or money order) to the Secretary of State, Business
Services, P.O. Box 5616, Montgomery, Alabama 36103-5616. The Secretary of State shall pay the sum of $100.00 to
the county treasurer for the county in which the office of the initial registered agent for that entity is located. If the credit
card does not authorize or if the check is dishonored, the filing will be removed from the index and of no legal effect. In
the case of a dishonored check, a $30 fee will be charged.
This form must be typed.
1. The name of the limited liability company (must contain the words “Limited Liability Company” or the abbreviation
“L.L.C.” or “LLC,” and comply with Code of Alabama, Title 10A-1-5.06. (You may use Professional or Series
before Limited Liability Company or LLC (or PLLC or SLLC) if they apply):
2. A copy of the Name Reservation certificate from the Office of the Secretary of State must be attached.
3. The name of the Registered Agent (only one agent):
Street (No PO Boxes) address of Registered Office (must be located in Alabama):
*COUNTY of above address:
Mailing address in Alabama of Registered Office (if different from street address):
4. The undersigned certify that there is at least one member of the limited liability company.
This form was prepared by: (type name and full address)
(For SOS Office Use Only)
LLC Cert of Formation – 01/2021 Page 2 of 2
5. Check only if the type applies to the Limited Liability Company being formed:
Series LLC complying with Title 10A, Chapter 5A, Article 11
Professional LLC complying with Title 10A, Chapter 5A, Article 8
Non-Profit LLC complying with 10A-5A-1.04(c)
6. T
he filing of the limited liability company is effective immediately on the date received by the office of the Secretary
of State, Business Services Division or at the delayed filing date (cannot be prior to the filing date) specified in
this filing. 10A-1-4.12
The undersigned specify / / as the effective
date (must be on or after the date filed in the
office of the Secretary of State, but no later than the 90th day after the date this instrument was signed) and the time
of filing to be : AM or PM. (cannot be noon or midnight – 12:00)
Attached are any other matters the members determine to include herein (if this item is checked there must be
attachments with the filing).
Date (MM/DD/YYYY) Signature as required by 10A-5A-2.04
Typed Name of Above Signature
Typed Title (Organizer or Attorney-in-fact)
Additional Organizers/Attorney-in-facts may sign (add additional sheets if necessary).
*County of Registered Agent is requested in order to determine distribution of County filing fees
Domestic Formation Credit Card/Prepaid Account Payment Slip – 1/2021
Secretary of State Credit Card or Prepaid Payment Option/Return/Hold Sheet: If you do not send
an acknowledgement copy and a pre-addressed postage paid envelope with the filing you will not receive
a receipt from the Secretary of State’s Office. Hold for pickup request will have the receipt attached. The
document of record will be stamped showing the receipt of the filing fee but will not show convenience
fees (generally these fees are between 2% and 5% of the total charge).
Information MUST be typed or filing will be returned without review.
Entity Name:
Service Requested: X $200.00 Formation filing fee
Hold at Front Desk for Pick-up by:
There is no notification service/call for pick-up. (Service providers who run couriers for pick-up)
Choose one of the following:
Check/money order is attached-Please make one check payable for each filing to the Alabama
Secretary of State. Do not use one check for multiple filings.
Charge fees to prepaid account: Account Number
and Account Name
Typed Name & Signature of Authorized Individual on Account
Credit Card Type: (Visa, MC, Discover & AmEx)
Card Number: Expiration Mo/Yr.: / (MM/YY)
Card Holder Name:
Complete Billing Address:
Street or PO
City State Zip
Signature of Card Holder:
MUST be Signature of Card Holder