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 REVIVER for FOREIGN LIMITED LIABILITY COMPANY 15-31-524, 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: $15.00 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 Limited Liability Company's business mailing address: _________________________________________________________ City:____________________________________________ State:________________________ Zip Code:___________________ 3. The Limited Liability Company submits with this application a Title 15, MCA, certificate obtained from the Montana Department of Revenue evidencing payment of delinquent taxes. 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 Date ____________________________________________________________ __________________________________________ Printed Name Title 4. 5. Daytime Contact: Phone __________________________________ Email ____________________________________________ sos.mt.gov/Business/Forms 22C-Reviver_of_Foreign_Limited_Liability_Company Revised: 09/2016 American LegalNet, Inc. www.FormsWorkFlow.com