Important: Read instructions before completing form. Non-Refundable Processing Fee: $22.00
1. Limited Liability Partnership name: The last words of the name must be "Limited Liability Partnership" or LLP.
___________________________________________________________________________________________________
(Name of Limited Liability Partnership in the Home State – see instructions for name requirements)
2. Tribal nation of qualification:
3. Principal office address:
____
___________________________________________________________________________________
Address City State Zip
4. 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:
5a. Partner Name & Address:
(Partners are optional)
Name: _________________________________________________________
__________________________________________________________
Street Address
_______________________________________________________________________________________
City State Zip
5b. Partner Name & Address:
(Partners are optional)
Name: _________________________________________________________
__________________________________________________________
Street Address
_______________________________________________________________________________________
City State Zip
6. The Limited Liability Partnership 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. Under penalties of perjury and as an authorized partner, I declare that this application, and if applicable, the statement of change of
registered office and/or agent, has been examined by me and is, to the best of my knowledge and belief, true, correct, and complete.
Authorized Signer Signature: Name & Title:
8. Purpose of the Limited Liability Partnership:
(optional)
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
Tribal Registration Statement (Limited Liability Partnership)
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
