COMMONWEALTH OF KENTUCKY TREY GRAYSON, SECRETARY OF STATE _________________________________________________________________________________________________________________________ Division of Corporations Business Filings PO Box 718 Frankfort, KY 40602 (502) 564-3490 www.sos.ky.gov Registration or Renewal LRG (Foreign Limited Liability Company) _________________________________________________________________________________________ Pursuant to the provisions of KRS Chapter 275, the undersigned applies for registration or renewal and, for that purpose, submits the following statements: 1. The activity request is: Registration Renewal 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 mailing address of the limited liability company is _________________________________________________________________________________________________ City State Zip Code Street Address or Post Office Box Numbers 6. The nature of the business of the limited liability company is _______________________________________________ (Please print brief description) _________________________________________________________________________________________________ _________________________________________________________________________________________________ We/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. We/I declare under penalty of perjury under the laws of Kentucky that the forgoing is true and correct. __________________________________________________________________________________________ Member, Manger or Authorized Party (09/09) Printed Name Title Date American LegalNet, Inc. www.FormsWorkFlow.com FILING INSTRUCTIONS REGISTRATION OR RENEWAL OF LIMITED LIABILITY COMPANY NAME REGISTRATION OR RENEWAL If the limited liability company is applying for renewal of registration of company name, check appropriate block. Please note: A registered name is st effective when filed with the Secretary of State and expires on December 31 of the same year. A registered name may be renewed for successive st st years between October 1 and December 31 of the preceding year. When the renewal is effective, it renews the company name registration for the following calendar year. NAME Use the exact name of the business entity as registered on file with the Office of the Secretary of State. 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 When filing online with the FastTrack system, no copies are required. If filing via mail or in person, one exact or conformed copy of the documents with the filing fee must be submitted to the address below. To make a copy of the filing for delivery to the local county clerk’s office, visit www.sos.ky.gov and print a copy from the organization search tool. DOCUMENT DELIVERY All documents will be sent to the return address on the outer envelope. If no address is found, the documents will be sent to the principal office. If the applicant wishes for correspondence from the Office of the Secretary of State to be sent to someone other than those above, a request must be submitted in writing affirming that request. All other communication and notification shall follow the process prescribed in Kentucky Revised Statute. FILING FEE The filing fee for this document is $36.00. Checks should be made payable to the "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 Hours of Operation: 8:00 AM-4:30 PM ET CONTACT INFORMATION AND NAME AVAILABILITY If you have any questions, need additional forms or wish to search for name availability, please feel free to visit our website at www.sos.ky.gov or call (502) 564-3490. (09/09) American LegalNet, Inc. www.FormsWorkFlow.com