Certificate Of Formation Form. This is a Mississippi form and can be use in Corporations Secretary Of State.
Tags: Certificate Of Formation, F0100, Mississippi Secretary Of State, Corporations
11 F0100 Page 1 of 2 OFFICE OF THE SECRETARY OF STATE P O BOX 136, JACKSON, MS 39205-0136 (601)359-1633 Mississippi LLC Certificate of Formation The undersigned hereby executes the following document and sets forth: (fields marked with an asterisks are required) 1. Name of the Limited Liability Company: (The name must include the words “Limited Liability Company” or the abbreviation “LLC” or “L.L.C.”) * 2. The future effective date is (Complete if Applicable) Business Email Address:____________________________ 3. Federal Tax ID if available (Do not put Social Security Number in the box) 4. Name and Street Address of the Registered Agent and Registered Office is (must be in Mississippi) *Name *Physical Address P.O. Box *City * State * Zip5 – Zip4 5. If the Limited Liability Company is to have a specific date of dissolution, the latest date upon which the Limited Liability Company is to dissolve is 6. Is full or partial management of the Limited Liability Company vested in a manager or managers? (Mark Appropriate box) * Yes No 7. Other matters the managers or members elect to include: (Attach additional pages if necessary) Rev. 04/2009 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 11 F0100 Page 2 of 2 OFFICE OF THE SECRETARY OF STATE P O BOX 136, JACKSON, MS 39205-0136 (601)359-1633 Certificate of Formation 8. Signatures: This certificate must be signed by at least one member, manager, or organizer. (If signed by “manager” box 6 on page one 1 should be marked “yes”.) The name, title, and address of each signer should be included in the spaces indicated. This page may be duplicated for additional signatures. * Printed Name * Title * By: Signature (please keep writing within blocks) Street and Mailing Address * Physical Address * P. O. Box * City State Zip5 – Zip4 Printed Name Title By: Signature (please keep writing within blocks) Street and Mailing Address Physical Address P. O. Box City State Zip5 – Zip4 Rev. 04/2009 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com