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Application for Authority to Transact Business - Foreign Limited Liability Company
Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 – sos.oregon.gov/business - Phone: (503) 986-2200
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REGISTRY NUMBER :
For office use only
In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record.
W e must release this information to all parties upon request and it will be posted on our website. For office use only
Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary.
1) NAME:
NOTE: (Must contain the words “Limited Liability Company” or the abbreviations “LLC” or “L.L.C.”) Must be identical to the name of record in home jurisdiction.
2) REGISTRYNUMBER IN HOME URISDICTIONJ 7) REGISTERED AGENT S ' PUBLICLY VAILABLE A DDRESSA :
OR: CERTIFICATE OF EXISTENCE (ATTACHED) (Must be an Oregon Street Addressiswhich , identical to the registered agent’s
business office.)
(Please provide a web-verifiable registry number from the entity’s home
jurisdiction. Certain states, such as Delaware and New Jersey, do not provide
status information online. Entities from such places must instead attach an
official certificate of existence, current within 60 days of delivery to this office.)
3) DATE OF ORGANIZATION : DURATION ,IF NOT PERPETUAL: 8) ADDRESS OF PRINCIPAL FFICEO OF THE USINESSB :
4) STATE OR COUNTRY OF RGANIZATIONO : 9) ADDRESSWHERE THE DIVISION MAY MAIL NOTICES :
5) THIS FOREIGN LIMITED LIABILITY COMPANY SATISFIES THE
REQUIREMENTSOFORS 63.714(3). 10)HOWWILL THIS IMITED L IABILITY L OMPANY C E B M ANAGED?
6) NAME OF OREGON EGISTERED R GENTA : This will be member-managedLLC by one or more members.
This LLC will be manager-managed by one or more managers.
11) EXECUTION: (At least one member or manager must sign.)
I declare as an authorized signer, under penalty of perjury, that this document does not fraudulently conceal, fraudulently obscure,
fraudulently alter or otherwise misrepresent the identity of the person or any members, managers, employees or agents of the limited
liability company. This filing has been examined by me and is, to the best of my knowledge and belief true, correct, and complete.
Making false statements in th is document is against the law and may be penalized by fines, imprisonment or both.
Signature: Printed Name: Title:
CONTACT NAME :resolve(To questions with this filing.) FEES
Required Processing Fee $275
Processing Fees are nonrefundable. Please make check payable to “Corporation Division.”
PHONE NUMBER :(Include area code.)
Free copies are available at sos.oregon.gov/business, using the Business Name Search program.
110 - Application for Authority to Transact Business - Foreign Limited Liability Company (11/17)
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