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Annual Report Form. This is a South Dakota form and can be use in Corporation Secretary Of State.
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Tags: Annual Report, South Dakota Secretary Of State, Corporation
Secretary of State Office
500 E Capitol Ave
Pierre, SD 57501
(605)773-4845
ANNUAL REPORT
FILE DATE
FOREIGN L.L.C.
____________________
RECEIPT NO ___________________
Please Type or Print Clearly in Ink
FILING FEE: $50 Make check payable to SECRETARY OF STATE
1. L.L.C. ID and Name:
Telephone # ____________________
FAX #
_______________________
FILING DATE: Due during the month
the Certificate of Authority was issued,
and delinquent after the last day of the
following month.
2. The jurisdiction under whose law it is formed ___________________________________________________________
3. The address of the principal executive office in or out of the State of South Dakota.
______________________________________________________________________________________________
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional)
City
State
ZIP+4
4. The name of the South Dakota Registered Agent _______________________________________________________
______________________________________________________________________________________________
Street Address (Required to be a South Dakota Address)
City
State
ZIP+4
______________________________________________________________________________________________
Mailing Address (Optional – Required to be a South Dakota Address)
City
State
ZIP+4
5. The names and business addresses of its managers. If the L.L.C. is member-managed the names and addresses of
the members need not be set forth.
______________________________________________________________________________________________
Manager
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Manager
Street Address
City
State
ZIP+4
______________________________________________________________________________________________
Manager
Street Address
City
State
ZIP+4
No person may execute this report knowing it is false in any material respect. Any violation is subject to a civil penalty.
Dated ____________________________
______________________________________________
(Signature of an Authorized Person)
______________________________________________
(Printed Name)
annualreportforeignllc July 2010
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