Important: Read instructions before completing form N
on-Refundable Processing Fee: $70.00
1. Exact Name of Foreign Limited Liability Company:
2. Tribal Nation of Formation:
3. Principal office address:
____________________________________________________________________________________________________
Address City State Zip
4. The debts, liabilities, and obligations incurred, contracted for, or otherwise existing with respect to this particular series, if any, are enforceable
against the assets of such series only, and not against the assets of the foreign limited liability company generally or any other series.
Yes No
5. The name of the Registered Agent (Individual or Business Entity or Commercial Registered Agent):
__________________________________________________________________________________________
The address must be listed if you have a non-commercial registered agent. See instructions for further details.
Address of the Registered Agent: _____________________________________________________________
Utah Street Address Required, PO Boxes can be listed after the Street Address
City: State UT
Zip:
6. The Limited Liability Company shall use as its name in Utah:
______________________________________________________________________________
Must be the same as number (1) unless the name is not available or permitted in Utah.
7. Purpose of the Limited Liability Company:
(optional)
8. Managers/Members of the Limited Liability Company:
(optional)
Position Name Address City State Zip
MANAGER:
MANAGER:
MEMBER:
MEMBER:
Under penalties of perjury, I declare that this application for authority to transact business has been examined by me and is, to the best of my knowledge and belief,
true, correct and complete.
Authorized Signature: Name & Title:
Under GRAMA {63G-2-201}, all registration
information maintained by the Division is classified as public record. For confidentiality purposes, you may
use the business entity physical address rather than the residential or private address of any individual affiliated with the entity.
Optional Inclusion of Ownership Information: This information is not required.
Is this a female owned business? Yes No
Is this a minority owned business? Yes No If yes, please specify:
State of Utah
Department of Commerce
Division of Corporations & Commercial Code
Foreign Registration Statement (Tribal Series Limited Liability Company)
This form must be type written or computer generated.
Sign here after the form is printed
Select/Type the race of the owner here
Mailing/Faxing Information:
www.corporations.utah.gov/contactus.html
www.corporations.utah.gov
