253 APPLICATION FOR CERTIFICATE OF AUTHORITY FOR FOREIGN LIMITED LIABILITY COMPANY (Instructions on back of application) 1. The name of the limited liability company is: _____________________________________________________________________ 2. If the name of the limited liability company is not permissible or is not available in Idaho, the name the foreign limited liability company will use in Idaho is: _____________________________________________________________________ 3. The jurisdiction under whose laws the limited liability company is formed is: ___________ 4. The name and complete street address of the registered agent in Idaho is: __________________________ _________________________________________ 5. The street and mailing address of the limited liability company's principal office is: _____________________________________________________________________ Street Address _____________________________________________________________________ Mailing Address, if different 6. The street and mailing address of the limited liability company's office in the jurisdiction under whose laws it is organized is: _____________________________________________________________________ Street Address _____________________________________________________________________ Mailing Address, if different 7. The name and mailing address of at least one member or manager: __________________________ _________________________________________ 8. The mailing address for future correspondence: ____________________________________________________________________ 9. Signature of a manager, member or authorized person. Secretary of State use only Signature Typed Name cert_auth_foreign_LLC Rev. 07/2010 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS Optional: If the document requires a correction, please list a telephone number where we can reach you. Note: Complete and submit the application in duplicate. This application must be accompanied by a certificate of existence (or goodstanding), dated within 90 days from the date of filing with the Idaho Secretary of State's Office. A certified copy of the organizational documents will NOT be accepted. Line 1. Enter the name of the limited liability company exactly as it reads from the certificate of existence from the domestic state. Line 2. Complete line 2 only if: (1) the LLC must adopt a fictitious name to avoid a conflict with an existing name on the records of the Secretary of State, or (2) the LLC's true name does not include one of the words or organization required by 30-6-108, Idaho Code. Line 3. Enter the domestic state of organization. Line 4. All Limited Liability Companies must have a registered agent in Idaho. A registered agent is the person designated to receive service of process upon litigation. A registered agent may be an individual who is a resident of Idaho, or a business entity registered with the Secretary of State's office. Assumed Business Name filings cannot be registered agents. This person or business entity must be located in Idaho at a physical address. Post Office boxes and commercial personal mail boxes are not acceptable. Line 5. Enter the complete street and mailing addresses of the limited liability company's principal office. Line 6. Enter the complete street and mailing addresses of the limited liability company's office in the jurisdiction under whose laws it is organized. Line 7. Enter the name and mailing address of at least one member or manager. Line 8. Enter the mailing address for future correspondence. Your annual report reminders will be mailed to this address. Line 9. The application for registration of foreign limited liability company must be signed by an authorized person. Please identify the name of the signer by typing his/her name below the signature. Enclose the appropriate fee: The filing fee is $100.00. If expedited service is requested, add $20.00 to the filing fee. If the fees are to be paid from the filing party’s pre-paid customer account, indicate the customer account number in the cover letter or transmittal document. The Secretary of State’s Office will delete a business entity filing from our database if payment for the filing is not completed. [67-910(6), Idaho Code] Mail or deliver to: Office of the Secretary of State 450 N. 4th Street PO Box 83720 Boise ID 83720-0080 If you have questions or need help, call the Secretary of State’s office at (208) 334-2301. American LegalNet, Inc. www.FormsWorkFlow.com