Version 2, Date: 3-17-2009 District of Columbia Government Corporations Division PO Box 92300 Washington DC 20090 Application for Certificate of Registration for Foreign Limited Liability Company Use this form to register your foreign Limited Liability Company (LLC). ENTITY TYPE Foreign Limited Liability Company FILING FEE $200, payable to DC Treasury 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. (Add LLC or PLLC if this designation is not required by the state of organization.) 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. (If you started business before you registered, contact Division for detailed instructions.) 7. Address of the company in the state where it is organized. (If the principal address is outside the state of organization, give the RA in the state of organization.) 8. Registered Agent's name and address of registered office in District of Columbia. (Attach Form RA-1 for RA's consent to this application.) 9. Briefly describe the proposed activity company will transact in the District of Columbia. (General purposes are acceptable in combination with specific purposes.) 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. (Certificate of good standing from Tax or Licensing Authority will not be sufficient.) 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 payments to: Department of Consumer and Regulatory Affairs Corporations Division P.O. Box 92300 Washington, DC 20090 Phone: (202) 442-4432 For overnight delivery send to: Corporate Bank of America Attention: DC Government Wholesale Lockbox #92300 Mail Code MD4-301-18-04 225 North Calvert Street – 18th floor Baltimore, Maryland 21202 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