MINNESOTA SECRETARY OF STATE DOMESTIC AND FOREIGN LIMITED LIABILITY COMPANY ANNUAL RENEWAL Minnesota Statutes Chapter 322B Must be filed by December 31 File online at https://online.sos.state.mn.us/abr/corp_annual_filing.asp READ INSTRUCTIONS ON BACK BEFORE COMPLETING THIS FORM CURRENT INFORMATION ON FILE: 1. File #: 2. This LLC is formed under the laws of: (Required) 3. Limited Liability Company Name: (Required) 4. Alternate Name, if any: (Foreign LLC only) 5. Registered Office Address: (Required) Agent’s Name: (if applicable)____________________________________________________________________ Street: ________________________________________City: ___________________State: _______Zip:_________ (A PO Box alone is not acceptable) 6. Principal Executive Office Address: (Required) Street:__________________________________________City:_________________State:_______Zip:________ (A PO Box alone is not acceptable) 7. Name and business address of manager or other person exercising the principal functions of the chief manager of the limited liability company: (Required) Name: _____________________________________________________________________________________ Street:__________________________________________City:_________________State:_______Zip:________ 8. Does this limited liability company own, lease, or have any financial interest in agricultural land or land capable of being farmed? Yes _____ No_____ 9. Name, daytime telephone number and e-mail address of a contact person: Name: __________________________________Phone: (_______)_________________________ Ext.________ E-Mail address: _______________________________________________________________________________ NOTICE: Failure to file this form by December 31 of this year will result in the termination or revocation of this limited liability company without further notice from the Secretary of State, pursuant to Minnesota Statutes, section 322B.960. American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS FOR COMPLETING THIS FORM All limited liability companies governed under Minnesota Statutes 322B are required to file an annual renewal once every calendar year. Items 3 through 5 are filed within the articles of organization; if there is a change to this information you must amend your articles of organization. The applicable amendment filing along with a $35.00 filing fee must be submitted at the same time as your annual renewal. You cannot use the annual renewal form to make changes to the information filed in the articles of organization. Items 6 through 9 can be changed once a year by filing the annual renewal form with our office or by entering it online at https://online.sos.state.mn.us/abr/corp_annual_filing.asp. PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK. 1. File Number: Provide the file number issued by the Minnesota Secretary of State. 2. This LLC is formed under the laws of: (Required) List the state of jurisdiction for the organization. 3. Limited Liability Company Name: (Required) List the LLC name on file with the Secretary of State's office. If changes to the company name are necessary one of the following forms will need to be submitted along with a $35.00 filing fee. An amendment for is necessary for a Minnesota LLC and a one page "Certificate of Fact" from the home state showing the old and new name is needed for a foreign LLC. 4. Foreign Limited Liability Name: List the alternate name used in Minnesota if one is currently on file with our office. 5. Registered Agent, if any and Registered Office Address: (Required) List the current registered agent, if any and registered office address. If changes to the registered agent or registered office address are necessary an amendment form and $35 fee must be included with the annual renewal. 6. Principal Executive Office Address: (Required) A complete street address or rural route and rural route box number is required. A post office box alone is not acceptable. 7. Name and Business Address of Manager: (Required) Fill in the name and complete business address of the manager or other person exercising the principal functions of the chief manager of the limited liability company. 8. Does the limited liability company own, lease, or have any financial interest in agricultural land or land capable of being farmed? This question is optional. Check Yes or No. 9. Name and daytime telephone number and/or e-mail address of contact person for the limited liability company: List a name, daytime telephone number and an e-mail address of a person who can be contacted about this form. A limited liability company that has been administratively terminated or has had its authority to do business in Minnesota revoked may retroactively reinstate its existence of authority to do business by filing a single annual renewal, and paying the $25.00 reinstatement fee. For your convenience the Office of the Secretary of State does provide standard forms for most filings. To obtain a copy of a form you can go to our web site at www.sos.state.mn.us, or contact us between 9:00am to 4:00pm, Monday through Friday at (651) 296-2803 or toll free 1-877-551-6SOS (6767). If this form is being mailed with an amendment form, please submit all items together and mail to the address below: FILE IN-PERSON OR MAIL TO: Minnesota Secretary of State – Renewals Minnesota State Retirement Building 60 Empire Drive, Suite 100 St Paul, MN 55103 (Staffed 8:00 – 4:00, Monday – Friday, excluding holidays) File online at https://online.sos.state.mn.us/abr/corp_annual_filing.asp All of the information on this form is public and required in order to process this filing. Failure to provide the requested information will prevent the Office from approving or further processing this filing. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)296-2803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service. bus68LLC&LFCRenewalRev12-06 American LegalNet, Inc. www.FormsWorkflow.com