State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.state.ak.us/occ APPLICATION FOR REGISTRATION Foreign Limited Liability Company INSTRUCTIONS: (Please retain for your records) If you need assistance in completing your filing, it is advised that you seek legal counsel. 1. Legal Name: The name of the limited liability company. A limited liability company name must contain the words “limited liability company ", or the abbreviation "L.L.C." or "LLC". A limited liability company name must be distinguishable upon the record. To search the availability of the legal name of the limited liability company in the State of Alaska go to the Corporations section at http://www.commerce.state.ak.us/occ and Search Corporations Database. Assumed Name: The name the limited liability company elects to use if the name in the state of domicile is already in use by another entity in Alaska. To search the availability of the legal name of the limited liability company in the State of Alaska go to the Corporations section at http://www.commerce.state.ak.us/occ and Search Corporations Database. 2.  State of Domicile  Date of Organization (mm/dd/yyyy) in the state of domicile.  Duration is the length of time a limited liability company expects to exist. It may be “Perpetual” or a specific future date (mm/dd/yyyy) of less than 100 years. 3. Registered Agent: The Registered Agent of the limited liability company must have an address in Alaska. If the registered office mailing address is a post office box, the physical address of the registered office must be listed. A limited liability company shall continuously maintain in this state a registered agent and a registered office. The registered office may be the same as the place of business of the limited liability company. The registered agent may be either an individual resident of this state whose business office is the same as the registered office, or a domestic or foreign corporation authorized to transact business in this state whose business office is the same as the registered office. A corporation may not act as its own Registered Agent. A limited liability company cannot be a registered agent. 4. The Department is appointed the agent of the company for service of process if the foreign limited liability company fails to appoint or maintain a registered agent under AS 10.50.635. Which in part states; A foreign limited liability company registered under this chapter shall have and continuously maintain in the state a registered agent and address. 5. Address of the Principal Office: Address of the administrative office of the company wherever located. 6. Email Address 7. Purpose: May include “any lawful”. NAICS: industry grouping six-digit code that most clearly describes the initial activities of the limited liability company. You may view or search NAICS Codes online at http://www.commerce.state.ak.us/occ 08-435 (Rev. 05/20/10) INSTRUCTIONS PAGE 1 OF 2 American LegalNet, Inc. www.FormsWorkFlow.com 8. Members: The limited liability company must have at least one member. Members of a limited liability company manage the affairs and make decisions of the company. Managers: If the company is managed by a manager the company must list the manager(s). Managers have the exclusive power to manage the affairs of the company to the extent authorized by the operating agreement. 9. Signature of a person who is authorized by the law of the state of domicile or other jurisdiction where the company was organized. If you have specific legal questions or concerns about this filing, you are strongly advised to consult an attorney or other professional to assist you. Mail pages 1 – 2 of the Application for Registration for Foreign Limited Liability Company and the $350.00 filing fee in U.S. dollars to: State of Alaska Corporations Section PO Box 110806 Juneau AK 99811-0806 For additional information or forms visit our website at www.commerce.state.ak.us/occ FOR IMMEDIATE PROCESSING, file the Application for Registration for Foreign Limited Liability Company ONLINE at: www.commerce.state.ak.us/occ. Online filing allows you to receive your Certificate of Registration that can be printed immediately from your home or office computer. INSTRUCTIONS PAGE 2 OF 2 08-435 (Rev. 05/20/10) American LegalNet, Inc. www.FormsWorkFlow.com State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.state.ak.us/occ DO NOT STAMP ABOVE THIS BOX CORP (OFFICE USE ONLY) APPLICATION FOR REGISTRATION Foreign Limited Liability Company Pursuant to the provisions of the Alaska Statutes, the undersigned limited liability company applies for a Certificate of Registration and, for that purpose, submits the following statement: 1. The legal name of the limited liability company: The name of a limited liability company must contain the words "limited liability company" or the abbreviation "L.L.C.," or "LLC": The assumed name elected to use in Alaska if the legal name in not available: 2. State of domicile, date of organization, and the period of duration in the state or country of domicile: Duration is the length of time the company expects to exist. It may be a specific future date (mm/dd/yyyy) of less than 100 years or “perpetual”. State of Domicile: Date of Organization: (mm/dd/yyyy) Duration: The limited liability company is active and in good standing in the state of domicile. 3. Registered Agent name and address: Must have a physical and mailing address in Alaska. Name: Mailing Address: AK ZIP Code: AK ZIP Code: Physical Address if Mailing Address is a Post Office Box: City: 4. The Department is appointed the agent of the company for service of process if the foreign limited liability company fails to appoint or maintain a registered agent under AS 10.50.635. Which in part states; A foreign limited liability company registered under this chapter shall have and continuously maintain in the state a registered agent and address. 5. Address of the administrative office of the company wherever located: Mailing Address: Physical Address if Mailing Address is a Post Office Box: City: ZIP Code: 6. Email Address: 08-435 (Rev. 05/20/10) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 7. The purpose of the company and the 6 digit NAICS industry grouping code that most clearly describe the initial activities of the company: Purpose: NAICS Code: 8. The limited liability company must have at least one member, and list the name, address and % held of each person/entity owning at least 5% in the company Member Name Mailing Address City State ZIP Code % Interest Held If the company is managed by a manager, list the name, address and % held (if applicable) of each manager in the company. Manager Name Mailing Address City State ZIP Code % Interest Held 9. The PRINTED name and SIGNATURE by a person who is authorized by the law of the state or other jurisdiction where the company was organized to sign the application: By signing this application for Certificate of Authority, I attest that the information set forth above is true and correct. Signature of Authorized Person Printed Name Title Date __ / __ / __ To resolve questions with this filing: Please be aware, this form will become public information. Contact Name Contact Phone Number If you have specific legal questions or concerns about this filing, you are strongly advised to consult an attorney or other professional to assist you. Mail the completed filing and the $350.00 filing fee in U.S. dollars to: State of Alaska Corporations Section PO Box 110806 Juneau AK 99811-0806 FOR IMMEDIATE PROCESSING, file the Application for Registration for Foreign Limited Liability Company ONLINE at: www.commerce.state.ak.us/occ. Online filing allows you to receive your Certificate of Registration that can be printed immediately from your home or office computer. 08-435 (Rev. 05/20/10) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com