COVER LETTER 
                                                 
TO: Registration Section 
    Division of Corporations 
 
SUBJECT:                                                                                             
                                Name of Limited Liability Company 
                                                 
Dear Sir or Madam: 
 
The enclosed Statement of Authority and fee(s) are submitted for filing. 
 
Please return all correspondence concerning this matter to the following: 
 
                          Name of Person 
 
                          Firm/Company 
 
                   Address 
 
               City/State and Zip Code 
 
               E-mail address: (to be used for future annual report notification) 
 
For further information concerning this matter, please call: 
 
                                                 at (         )                                      
               Name of Person                           Area Code          Daytime Telephone Number 
 
    Mailing Address:                                          Street Address: 
    Registration Section                                      Registration Section 
    Division of Corporations                                  Division of Corporations 
    P.O. Box 6327                                             The Centre of Tallahassee 
    Tallahassee, FL 32314                                     2415 N. Monroe Street, Suite 810 
                                                              Tallahassee, FL 32303 
                                                 
CR2E138 (2/14) 

                                       STATEMENT OF AUTHORITY 
                                                        
Pursuant to section 605.0302(1), Florida Statutes, this limited liability company submits the following statement of 
authority: 
 
FIRST:  The name of the limited liability company is:                                                                 
 
SECOND:  The Florida Document Number of the limited liability company is:                                             
 
THIRD:  The street address of the limited liability company’s principal office is: 
 
         The mailing address of the limited liability company’s principal office is: 
 
FOURTH:  This statement of authority grants or sets limitations of authority on all persons having the status or 
position of a person in a company, whether as a member, transferee, manager, officer or otherwise or to a specific 
person on the following: 
 
      1.   May execute an instrument transferring real property held in the name of the company. 
            
               a. Granted to:                                                          
                   
               b. No authority granted to:                                             
                   
      2.    May enter into other transactions on behalf of, or otherwise act for or bind, the company. 
            
               a. Granted  to :                                                        
                   
               b. No authority granted to:                                             
                   
____________________________________                           ________________________________ 
Signature of authorized representative                            Typed or printed name of signature 
                                       Filing Fee:      $25.00 
                                       Certified Copy:  $30.00 (optional) 

CR2E138 (2/14)