Instructions for Completing Form LLC-12NC Statement of No Change Every California and registered foreign limited liability company must file a Statement of Information with the Secretary of State, within 90 days after the filing of its original Articles of Organization or Application for Registration, and every two years thereafter during a specific 6-month filing period based on the original file date, as described in the chart below. This Statement of No Change (Form LLC-12NC) may be used in lieu of the Statement of Information only if a previous complete Statement of Information has been filed with the Secretary of State and if there has been no change in any of the information contained in the previous complete Statement of Information. Changes to information contained in a previously filed Statement of Information can be made by filing a new Form LLC-12, completed in its entirety. See chart below for more information. Filing Fees: A $20.00 filing fee is required with this Statement of No Change. Checks should be made payable to the Secretary of State. Copies: To obtain a copy of this filed Statement of No Change, include payment for copy fees and certification fees at the time this Statement of No Change is submitted. The copy fee is $1.00 per copy. For certified copies, there is an additional $5.00 certification fee, per document. Type of Filing Initial Filing Description The initial filing is due 90 days from the entity’s registration date. • The periodic filing is due every two years based on the entity’s registration date. • If the registration occurred in an evennumbered year, the periodic filing is due every even year. • If the registration occurred in an oddnumbered year, the periodic filing is due every odd year. • The filing period includes the registration month and the immediately preceding five (5) months. A Statement of Information is submitted after the initial or required filing requirements have been met to update information including changes to the agent for service of process. Required Periodic Filing No Fee Statement Form to Use Statement of Information - Form LLC-12 Fee $20.00 Statement of No Change - Form LLC-12NC, if no changes since the last complete Statement of Information $20.00 or Statement of Information - Form LLC-12, if changes have been made Statement of Information - Form LLC-12 No Fee Statutory Required 6 Month Filing Window for Limited Liability Companies Month of Formation, Registration or Conversion Statement of Information Applicable Filing Period First Day of Through Last Day of January August January February September February October March April November April May December May June January June July February July March August September April September October May October November June November December July December March August LLC-12NC - Instructions (EST 05/2016) American LegalNet, Inc. www.FormsWorkFlow.com 2016 California Secretary of State www.sos.ca.gov/business/be If you are not completing this form online, please type or print legibly in black or blue ink. Complete the Statement of No Change (Form LLC-12NC) as follows: Item 1. Instruction Enter the name of the limited liability company exactly as it appears on file with the California Secretary of State, including the entity ending (ex: “Jones & Company, LLC” or “Smith Construction, a Limited Liability Company”). Tips • Some foreign limited liability companies may have registered using an alternate name. 2. Enter the 12 digit file number issued by the California Secretary of State. • The 12 digit file number is provided by the Secretary of State above the file stamp at the top of the limited liability company’s first registration document filed with the California Secretary of State. • To ensure you have the correct file number and exact name of the limited liability company, look to your registration documents filed with the California Secretary of State and any name change amendments. • Secretary of State Records can be accessed online through our Business Search at kepler.sos.ca.gov. While searching the Business Search, be sure to identify your entity correctly including the jurisdiction that matches your entity. 3. If formed outside of California, enter the state or place where the limited liability company was organized. • The jurisdiction must match the Secretary of State’s records. • The jurisdiction of record with the Secretary of State can be researched online through our Business Search at kepler.sos.ca.gov. 4. The No Change Statement must not be altered. If there have been any changes to the information provided on the last complete Statement of Information on file with the Secretary of State, complete a new Statement of Information (Form LLC-12). Return Address (Optional): To make it easier to receive communication related to this document, including the purchased copy of the filed document, if any, enter the name of a designated person or company and the corresponding mailing address. Please note that the listed name and mailing address will be a matter of public record, along with the rest of the information provided in this filed document. If you prefer, you may include a name and address on a separate page for this purpose. That separate page will not be made a part of the filing. Where to File: The completed forms along with the applicable fees can be mailed to Secretary of State, Statement of Information Unit, P.O. Box 944230, Sacramento, CA 94244-2300 or delivered in person (drop off) to the Sacramento office, 1500 11th Street, Sacramento, CA 95814. Legal Authority: Statutory filing provisions are found in California Corporations Code section 17702.09, unless otherwise indicated. All statutory references are to the California Corporations Code, unless otherwise stated. Failure to file this Statement of No Change or a completed Statement of Information by the due date will result in the assessment of a $250.00 penalty. (Sections 17713.07(b) and 17713.09; California Revenue and Taxation Code section 19141.) LLC-12NC - Instructions (EST 05/2016) American LegalNet, Inc. www.FormsWorkFlow.com 2016 California Secretary of State www.sos.ca.gov/business/be Secretary of State Statement of No Change (Limited Liability Company) FORM LLC-12NC IMPORTANT — Read instructions before completing this form. This form may be used only if a complete Statement of Information has been filed previously. Filing Fee - $20.00 Copy Fee - $1.00, Certification Fee - $5.00 per document This Space For Office Use Only 1. Limited Liability Company Name (Enter the name of the limited liability company exactly as it is of record with the California Secretary of State) 2. 12-Digit Secretary of State File Number 3. State or Place of Organization (only if formed outside of California) 4. No Change Statement (Do not alter the No Change Statement. If there has been any change, please complete a Statement of Information (Form LLC-12)) There has been no change in any of the information contained in the previous complete Statement of Information filed with the California Secretary of State. 5. The information contained herein is true and correct. ___________________ Date ___________________________________ Type or Print Name of Person Completing the Form _____________________ Title ____________________________________ Signature Return Address (Optional) (For communication from the Secretary of State related to this document, or if purchasing a copy of the filed document, enter the name of a person or company and the mailing address. This information will become public when filed. (SEE INSTRUCTIONS BEFORE COMPLETING.) Name:     Company: Address: City/State/Zip: LLC-12NC (EST 05/2016) American LegalNet, Inc. www.FormsWorkFlow.com 2016 California Secretary of State www.sos.ca.gov/business/be