Prepare, sign, and submit with an original signature and filing fee. This is the minimum information required. STATE OF MONTANA (This space for Secretary of State use only) APPLICATION for REINSTATEMENT for DOMESTIC LIMITED LIABILITY COMPANY 35-8-912, MCA MAIL: LINDA McCULLOCH Secretary of State P.O. Box 202801 Helena, MT 59620-2801 (406) 444-3665 (406) 444-3976 sos.mt.gov PHONE: FAX: WEB SITE: Required Filing Fee: $35.00 plus annual reports 24 Hour Priority Handling check box and Add $20.00 1 Hour Expedite Handling check box and Add $100.00 Folder ID Number: _________________ The folder number begins with a "C" and may be referenced at https://www.mtsosfilings.gov. Make checks payable to Secretary of State. If the document is hand written, please print legibly or the application may be denied. 1. The exact name of the Limited Liability Company: ________________________________________________________________________________________________________ 2. The business mailing address of its principal office:_______________________________________________________________ City: ______________________________________________________ Zip Code: _____________________________________ 3. 4. 5. The assets of the Limited Liability Company have not been liquidated. A majority of the Limited Liability Company's members have authorized this Application of Reinstatement. If the Limited Liability Company name has been legally acquired by another business entity prior to its Application for Reinstatement, the Limited Liability Company desires to be reinstated with the new name of: ________________________________________________________________________________________________________ 6. Attached are all Annual Reports as required by the Montana Secretary of State and (a) Pursuant to 35-8-912, MCA, a certificate from the Department of Revenue stating that all taxes imposed pursuant to Title 15, MCA, have been paid must be attached. You may contact them at (406) 4446900; PO Box 5805, Helena, MT 596205805. (b) Check this box if this Limited Liability Company has only one member and has elected not to be taxed as a corporation. Pursuant to 35-8-912, MCA, a certificate from the Montana Department of Revenue is not required. OR 7. I, HEREBY SWEAR AND/OR AFFIRM, under penalty of law, including criminal prosecution, that the facts contained in this document are true. __________________________________________________________________ Signature of Managing Member/Managing Manager ___________________________________________________________ Printed Name ____________________________________ Date ___________________________________________ Title 8. Daytime Contact: Phone __________________________________ Email_____________________________________________ sos.mt.gov/Business/Forms 22A-Reinstatement_of_Domestic_LLC Revised: 09/2016 American LegalNet, Inc. www.FormsWorkFlow.com