State of Missouri Corporations Division PO Box 778 / 600 W. Main St., Rm. 322 Jefferson City, MO 65102 John R. Ashcroft, Secretary of State 1. The name of the foreign limited liability company is: Application for Registration of a Foreign Limited Liability Company (Submit with filing fee of $105.00) 2. The name under which the foreign limited liability company will conduct business in Missouri is (must contain "limited company, "limited liability company", "LC", "LLC", "L.C.", or "L.L.C.") (must be filled out if different from line (1)): 3. The foreign limited liability company was formed under the laws of date of (month/day/year) 4. The purpose of the foreign limited liability company or the general character of the business it proposes to transact in this state is: . (state or jurisdiction) on the 5. The name and address of the limited liability company's registered agent in Missouri is (this line must be completed and include a street address): Name Address (PO Box may only be used in conjunction with a physical street address) City/State/Zip The Secretary of State is appointed agent for service of process if the foreign limited liability company fails to maintain a registered agent. Note: failure to maintain a registered agent constitutes grounds to cancel the registration of the foreign limited liability company. 6. The address of the registered office in the jurisdiction organized. If none required, then the principal office address of the foreign limited liability company is: Address (PO Box may only be used in conjunction with a physical street address) City/State/Zip 7. This application must include a current certificate of good standing/existence from the secretary of state or other similar official in the state of domicile. Such document should be dated within 60 calendar days from filing. (Please see next page) Name and address to return filed document: Name: Address: City, State, and Zip Code: LLC-4 (01/2017) American LegalNet, Inc. www.FormsWorkFlow.com 8. o Series LLC (OPTIONAL) Pursuant to Section 347.186, the foreign limited liability company may establish a designated series in its operating agreement. The names of the series must include the full name of the limited liability company under which it has been admitted to transact business in this state and are the following: New Series: o The limited liability company gives notice that the series has limited liability. New Series: o The limited liability company gives notice that the series has limited liability. New Series: o The limited liability company gives notice that the series has limited liability. (Each separate series must also file an Attachment Form LLC 4A.) In Affirmation thereof, the facts stated above are true and correct. (The undersigned understands that false statements made in this filing are subject to the penalties provided under Section 575.040, RSMo) Authorized Signature Authorized Signature Authorized Signature Printed Name Printed Name Printed Name Date Date Date LLC-4 (01/2017) American LegalNet, Inc. www.FormsWorkFlow.com