Application for Certification of Authority For Limited Liability Company

State+of+North+Carolina+Department+of+the+Secretary+of+State+APPLICATION+FOR+CERTIFICATE+OF+AUTHORITY+FOR+LIMITED+LIABILITY+COMPANY%0d%0aPursuant+to+%c2%a757C-7-04+of+the+General+Statutes+of+North+Carolina%2c+the+undersigned+limited+liability+company+hereby+applies+for+a+Certificate+of+Authority+to+transact+business+in+the+State+of+North+Carolina%2c+and+for+that+purpose+submits+the+following%3a+1.+The+name+of+the+limited+liability+company+is+____________________________________________________________%3b+and+if+the+limited+liability+company+name+is+unavailable+for+use+in+the+State+of+North+Carolina%2c+the+name+the+limited+liability+company+wishes+to+use+is+______________________________________________________________________+2.+The+state+or+country+under+whose+laws+the+limited+liability+company+was+formed+is%3a+______________________________+3.+The+date+of+formation+was+____________________________%3b+its+period+of+duration+is%3a+___________________________+4.+Principal+office+information%3a+(Select+either+a+or+b.)%0d%0a%0d%0aa.%0d%0a%0d%0aThe+limited+liability+company+has+a+principal+office.+The+street+address+and+county+of+the+principal+office+of+the+limited+liability+company+is%3a+Number+and+Street_________________________________________________________________+City%2c+State%2c+Zip+Code___________________________________________County______________+The+mailing+address%2c+if+different+from+the+street+address%2c+of+the+principal+office+of+the+corporation+is%3a+________________________________________________________________________________%0d%0a%0d%0ab.%0d%0a%0d%0aThe+limited+liability+company+does+not+have+a+principal+office.%0d%0a%0d%0a5.+The+street+address+and+county+of+the+registered+office+in+the+State+of+North+Carolina+is%3a+Number+and+Street+_______________________________________________________________________________+City%2c+State%2c+Zip+Code+__________________________________________________+County+____________________+6.+The+mailing+address%2c+if+different+from+the+street+address%2c+of+the+registered+office+in+the+State+of+North+Carolina+is%3a+_______________________________________________________________________________________________+7.+The+name+of+the+registered+agent+in+the+State+of+North+Carolina+is%3a+__________________________________________%0d%0a%0d%0aCORPORATIONS+DIVISION+(Revised+January+2002)%0d%0a%0d%0aP.+O.+BOX+29622%0d%0a%0d%0aRALEIGH%2c+NC+27626-0622+(Form+L-09)%0d%0a%0d%0a%0cAPPLICATION+FOR+CERTIFICATE+OF+AUTHORITY+Page+2+8.+The+names%2c+titles%2c+and+usual+business+addresses+of+the+current+managers+of+the+limited+liability+company+are%3a+(use+attachment+if+necessary)+Name+___________________________________________+___________________________________________+___________________________________________+___________________________________________+___________________________________________+Business+Address+_________________________________________________________+_________________________________________________________+_________________________________________________________+_________________________________________________________+_________________________________________________________%0d%0a%0d%0a9.+Attached+is+a+certificate+of+existence+(or+document+of+similar+import)%2c+duly+authenticated+by+the+secretary+of+state+or+other+official+having+custody+of+limited+liability+company+records+in+the+state+or+country+of+formation.+The+Certificate+of+Existence+must+be+less+than+six+months+old.+A+photocopy+of+the+certification+cannot+be+accepted.+10.+If+the+limited+liability+company+is+required+to+use+a+fictitious+name+in+order+to+transact+business+in+this+State%2c+a+copy+of+the+resolution+of+its+managers+adopting+the+fictitious+name+is+attached.+11.+This+application+will+be+effective+upon+filing%2c+unless+a+delayed+date+and%2for+time+is+specified%3a+_________________________+This+the+____day+of+________________%2c+20___%0d%0a%0d%0a____________________________________________________+Name+of+Limited+Liability+Company+____________________________________________________+Signature+of+Manager+____________________________________________________+Type+or+Print+Name%0d%0a%0d%0aNotes%3a+1.+Filing+fee+is+%24250.+This+document+must+be+filed+with+the+Secretary+of+State.+CORPORATIONS+DIVISION+(Revised+January+2002)+P.+O.+BOX+29622+RALEIGH%2c+NC+27626-0622+(Form+L-09)%0d%0a%0d%0a%0c