District of Columbia Government Corporations Division Application for Certificate of Registration for Foreign Limited Liability Company Form FLC-1, Version 6, July 2010. Use this form (FLC-1) to register your foreign Limited Liability Company (LLC). Review instruction sheet on page 1 before filing this form. ENTITY TYPE Foreign Limited Liability Company FILING FEE Refer to Corporate Fee Schedule posted online; Under the provisions of the Limited Liability Company Act, DC Official Code Title 29 Chapter 10, the company listed below hereby applies for a Certificate of Registration to transact business in the District of Columbia, and for that purpose submits the statement below. 1. Entity Name. 2. Company Designation elected in the District of Columbia. 3. Organized under the laws of which state or country. 4. Date of Organization. 5. Term of Existence. 6. Date company started or will start transacting business in the District of Columbia. 7. Address of the company in the state where it is organized. 8. Registered Agent's name and address of registered office in District of Columbia. 9. Briefly describe the proposed activity company will transact in the District of Columbia. 10. List all managers and members of the Limited Liability Company TITLE NAME ADDRESS 11. It is authorized to pursue such purpose in the state or country under the laws of which it is organized. 12 Attach an original Certificate of Good Standing (Certificate of Existence) from Registration Authority in the State/Country of Incorporation that is not over 30 days old. If you sign this application, you agree that you understand that anyone who makes a false statement anywhere on it can be punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC § 22-2405. 13. Select Company Representative executing this form. 14. Signature. Manager Member Authorized Person Mail all forms and required payment to: Department of Consumer and Regulatory Affairs Corporations Division PO Box 92300 Washington, DC 20090 Phone: (202) 442-4400 Please check dcra.dc.gov to view organizations required to register, to search business names, to get step-by-step guidelines to register an organization, to search registered organizations, and to download forms and documents. Just click on "Corporate Registrations." American LegalNet, Inc. www.FormsWorkFlow.com