State of Utah DEPARTMENT OF COMMERCE Division of Corporations & Commercial Code Application for Authority to Transact Business for a Foreign Limited Liability Company A Certificate of Good Standing/Existence from the state of organization dated no earlier than ninety (90) days prior to filing with the Division is attached. Non-Refundable Processing Fee: [ ] Foreign LLC $52.00 [ ] Series LLC $52.00 [ ] Tribal LLC $52.00 1. Exact Name of Foreign Limited Liability Company: 2. This limited liability company of the state/country/tribal nation of: 4. Duration: 3. Date of formation or organization in home state: 5. Is the registered agent a commercial registered agent? If Yes, is the commercial registered agent an: YES Individual NO Entity If an individual, what is the name of the individual (First, Middle, Last): __________________________________________ What is the Commercial Registered Agent Registration Number? (required): _________________________________________ Registered Agent Name: __________________________________________________________________________________ I hereby accept appointment as Registered Agent for the above named business entity. Signature of Registered Agent (Required): __________________________________________ Address of the Registered Agent: __________________________________________________________ Utah Street Address Required, PO Boxes can be listed after the Street Address City: ________________________________________________________________ 6. Principal place of business: State UT Zip: _______________ ________________________________________________________________ Street Address City State Zip 7. The nature of the business or purpose(s) to be conducted or promoted in Utah: 8. The limited liability company shall use as its name in Utah: ____________________________________________________________________________ (The limited liability company shall use its name as set forth at the top of this form unless the name is not available for use in Utah.) 9. Clear indication of who is managing the company is required. 10a. Is this foreign limited liability company manager-managed? _____ Yes, ______ No If YES, you must list the name and business or residence street address of each manager. Position Name Address City State Zip MANAGER: MANAGER: 10b. Is this foreign limited liability company member-managed? _____ Yes, _____ No If YES, you must list the name and business or residence street address of each member. Position Name Address City State Zip MEMBER: MEMBER: Please list additional managers/members (if any) on an attachment 11. If a foreign entity is a member or manager, you must list the home state where the entity is registered: 12. The date the limited liability company intends to first transact business in Utah: Under penalties of perjury, I declare as a manager or member with management authority of this limited liability company having authority to sign hereto, that this application for authority to transact business has been examined by me and is, to the best of my knowledge and belief, true, correct and complete. __________________________ __________________________ Limited Liability Company Authorized Signer Signature Name & Title Under GRAMA {63-2-201}, 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. American LegalNet, Inc. www.FormsWorkflow.com