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Statement Of Registration Form. This is a Wyoming form and can be use in Corporations Secretary Of State.
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Tags: Statement Of Registration, Wyoming Secretary Of State, Corporations
Wyoming Secretary of State
State Capitol Building, Room 110
200 West 24th Street
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Fax 307.777.5339
Email: business@state.wy.us
For Office Use Only
Foreign Registered Limited Liability Partnership
Statement of Registration
1. Name of the registered limited liability partnership:
2. Mailing address of the registered limited liability partnership:
3. Jurisdiction under the laws of which govern its partnership agreement and under which it is registered as a limited
liability partnership:
(State or country of organization)
4. Principal office address which, if in this state, shall be its registered office for service of process and the name of its
registered agent:
(The registered agent may be an individual resident in Wyoming, a domestic corporation, or foreign corporation authorized to transact
business in Wyoming, having a business office identical with such registered office. The registered agent must have a physical address in
Wyoming. A Post Office Box or Drop Box is not acceptable. If the registered office includes a suite number, it must be included in the
registered office address.)
5. If the partnership’s principal office is not located in this state, the address of a registered office and the name and
address of a registered agent for service of process in this state, which the partnership will be required to maintain:
6. Brief statement of the business in which the partnership engages:
7. Any other information:
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8. This partnership is a registered limited liability partnership.
9. This statement of registration has been executed by one (1) or more partners authorized to execute a statement of
registration.
Date:
Signature: ___________________________________________
(mm/dd/yyyy)
Print Name:
Title:
Date:
Signature: ___________________________________________
(mm/dd/yyyy)
Print Name:
Title:
Date:
Signature: ___________________________________________
(mm/dd/yyyy)
Print Name:
Title:
Contact Person:
Daytime Phone Number:
Checklist
Filing Fee: $100.00 Make check or money order payable to Wyoming Secretary of State.
The Registration must be accompanied by a written consent to appointment executed by the registered agent.
For consistency the Secretary of State’s Office will only keep one version of the agent’s name on file.
A certificate of existence/good standing or document of similar import must accompany the application.
Please submit one originally signed document and one exact photocopy of the filing.
Please review form prior to submitting to the Secretary of State to ensure all areas have been
completed to avoid a delay in the processing of your documents.
FRLLP-StatementRegistration - Revised 12/2008
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Wyoming Secretary of State
State Capitol Building, Room 110
200 West 24th Street
Cheyenne, WY 82002-0020
Ph. 307.777.7311
Fax 307.777.5339
Email: business@state.wy.us
Consent to Appointment by Registered Agent
I,
, registered office located at
(name of registered agent)
voluntarily consent to serve
* (registered office physical address, city, state & zip)
as the registered agent for
(name of business entity)
I hereby certify that I am in compliance with the requirements of W.S. 17-28-101 through W.S. 17-28-111.
Signature:__________________________________________
Date:
(Shall be executed by the registered agent.)
Print Name:
Daytime Phone:
Title:
(mm/dd/yyyy)
Email:
Registered Agent Mailing Address
(if different than above):
*If this is a new address, complete the following:
Previous Registered Office(s):
I hereby certify that:
x After the changes are made, the street address of my registered office and business office will be identical.
x This change affects every entity served by me and I have notified each entity of the registered office change.
x I certify that the above information is correct and I am in compliance with the requirements of W.S. 17-28-101 through
W.S. 17-28-111.
Signature: __________________________________________
Date:
(Shall be executed by the registered agent.)
(mm/dd/yyyy)
Checklist
Submit one originally signed consent to appointment and one exact photocopy.
RAConsent – Revised 10/21/2009
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