Kentucky Secretary of State TREY GRAYSON _________________________________________________________________________________________________ Division of Corporations BUSINESS FILINGS Application for Registration or Renewal of Limited Liability Company Name P.O. Box 718 Frankfort, KY 40602 (502) 564-2848 http://www.sos.ky.gov/ LRG ________________________________________________________________________ Pursuant to the provisions of KRS Chapter 275, the undersigned hereby applies for registration or renewal of its company name on behalf of the limited liability company named below and for that purpose submits the following statements: 1. Registration Renewal (CHECK ONE) 2.The name of the limited liability company is ______________________________________________________________________. 3. The state or country of organization is _____________________________________. 4. The date of organization is ______________________________________________. 5. The nature of the business of the limited liability company is ______________________________________________________________________ (Brief Description) ______________________________________________________________________. I certify that, as of the date of filing this application, the above named foreign limited liability company validly exists as a limited liability company under the laws of the jurisdiction of its formation. _________________________________________ Signature _________________________________________ Type or Print Name & Title _________________________________________ Street Address _________________________________________ City State Zip Code Date:___________________________, 20_______ LRG (06/07) (See attached sheet for instructions) American LegalNet, Inc. www.FormsWorkflow.com Application for Registration of Limited Liability Company Name Filing Instructions REGISTRATION OR RENEWAL If the limited liability company is applying for registration of company name, check appropriate block. If the limited liability company is applying for renewal of registration of company name, check appropriate block. LIMITED LIABILITY COMPANY NAME Use the exact name of the limited liability company as filed in its state of organization. DATE OF ORGANIZATION The date of organization is the date the limited liability company was organized in the state or country of its organization. NATURE OF BUSINESS The limited liability company must give a brief description of the nature of the business in which it is engaged. WHO MAY SIGN If management of the limited liability company is vested in one or more managers, a manager must sign the application. If management is reserved to the members, a member must sign. Type or print name, title and the street address of the applicant. NUMBER OF COPIES Submit the original signed application and one exact or conformed copy. (May be photocopy). One file-stamped copy will be returned to the limited liability company as evidence of filing. FILING FEES The filing fee for registration or renewal of limited liability company name is $36.00. Your check should be made payable to “Kentucky State Treasurer.” MAILING ADDRESS Trey Grayson Secretary of State P. O. Box 718 Frankfort, KY 40602-0718 OFFICE LOCATION Room 154, Capitol Building 700 Capital Avenue Frankfort, KY 40601 WEB SITE ADDRESS Our home page address is www.sos.ky.gov Click on “On Line Business Database” for information on status of all business entities in Kentucky. Forms are also available on our web site. For name availability, call (502) 564-2848, press 2, and then press 1. For further information, call (502) 564-2848, press 2, and then press 3 or try our web site. NOTE: A registered name is effective when filed with the Secretary of State and expires on December 31st of the same year. A registered name may be renewed for successive years between October 1st and December 31st of the preceding year. When the renewal is effective, it renews the company name registration for the following calendar year. American LegalNet, Inc. www.FormsWorkflow.com