JAY DARDENNE SECRETARY OF STATE
STATE OF LOUISIANA SECRETARY OF STATE
Commercial (225) 925-4704 (225) 922-0435 Fax Administrative Services (225) 925-4704 (225) 925-4726 Fax Uniform Commercial Code (225) 922-1193 (225) 922-0452 Fax
TRANSMITTAL INFORMATION For All Business Filings Please indicate below the level of service requested, payment and contact information
Routine Expedite $30 Check or Money Order Enclosed Credit Card Number: Expiration Date:
24 hour processing
Business Name (List exactly as it appears in documents)
Name of person filing document (evidence of filing will be mailed to this person, at address below)
Address
City
State
Zip Code
Daytime phone number
Fax number
Email address
NOTE: Louisiana Law requires all Louisiana notaries to print or type their name and notary or bar roll number on the document.
Mailing Address: P. O. Box 94125, Baton Rouge, LA * 70804-9125 Office Location: 8585 Archives Ave., Baton Rouge, LA * 70809 Web Site Address: www.sos.louisiana.gov
SS984 Rev. 10/08
Jay Dardenne Secretary of State
NOTICE OF CHANGE OF MEMBER(S) AND/OR MANAGER(S)
Enclose $25 Filing Fee Domestic Limited Liability Company Make remittance payable to Secretary of State Do Not Send Cash Return to: Commercial Division P. O. Box 94125 Baton Rouge, LA 70804-9125 Phone (225) 925-4704 Web Site: www.sos.louisiana.gov
Limited Liability Company Name:
REMOVAL OF MEMBERS AND/OR MANAGERS Notice is hereby given that the above named limited liability company has authorized the removal of the following Members and Managers:
To be signed by a member or manager
Date
ADDITION OF MEMBERS AND/OR MANAGERS Notice is hereby given that the above named limited liability company has authorized the addition of the following Members and Managers
To be signed by a manager or member
Date
SS983A Rev. 02/09
(See instructions on back)
INSTRUCTIONS
1. 2.
This form is to be used when an existing domestic limited liability company changes the Member(s) and/or Manager(s). The Change of Member(s) and/or Manager(s) must be signed by a manager, if management of the limited liability company is vested in one or more managers, or by at least one member, if management of the limited liability company is reserved to the members.