Free Fillable Application for Authority Form - New York

New York State Department of State Division of Corporations, State Records and Uniform Commercial Code One Commerce Plaza, 99 Washington Ave. Albany, NY 12231 www.dos.state.ny

APPLICATION FOR AUTHORITY OF
(Insert name of Foreign Limited Liability Company)

Under Section 802 of the Limited Liability Company Law

FIRST: The name of the limited liability company is:
If the name does not contain a required word or abbreviation pursuant to Section 204 of the Limited Liability Company Law, the following word or abbreviation is added to the name for use in this state: (Do not complete this section unless the limited liability company's true name is not available pursuant to §204 of the Limited Liability Company Law.) The fictitious name under which the limited liability company will do business in New York is:

SECOND: The jurisdiction of organization of the limited liability company is:
. The date of its organization is:

. .

THIRD: The county within this state in which the office, or if more than one office, the
principal office of the limited liability company is to be located is: (A county in New York State must be stated. Please note that the limited liability company is not required to have an actual physical office in this state.)

whom process against it may be served. The address within or without this state to which the Secretary of State shall mail a copy of any process served against him or her is:

FOURTH: The Secretary of State is designated as agent of the limited liability company upon

DOS-1361 (Rev. 7/08)

FIFTH: (Complete the statement that applies)
The address of the office required to be maintained in the jurisdiction of its formation is:

If no office is required to be maintained in the jurisdiction of its formation, the address of the principal office of the limited liability company is:

the time of filing of this application.

SIXTH: The foreign limited liability company is in existence in its jurisdiction of formation at SEVENTH: The name and address of the Secretary of State or other authorized official in its
jurisdiction of organization where a copy of its articles of organization is filed is:

X
(Signature)

(Type or print name)

(Title or capacity of signer)

Please Note: A certificate of existence or, if no such certificate is issued by the jurisdiction of formation, a certified copy of the articles of organization of the limited liability company and all subsequent amendments therefore, or if no articles of organization have been filed, a certified copy of the certificate filed as its organizational base and all amendments thereto, must be attached to the application for authority when submitted for filing. If such certificate or certified copy is in a foreign language, a translation in English thereto under oath of the translator shall be attached.

APPLICATION FOR AUTHORITY OF

(Insert name of Foreign Limited Liability Company) Under Section 802 of the Limited Liability Company Law

Filed by:

(Name) (Mailing address) (City, State and Zip code)

NOTE: This form was prepared by the New York State Department of State for filing an application for authority for a foreign limited liability company to conduct business in New York State. It does not contain all optional provisions under the law. You are not required to use this form. You may draft your own form or use forms available at legal supply stores. The Department of State recommends that legal documents be prepared under the guidance of an attorney. The certificate must be submitted with a $250 filing fee made payable to the Department of State. (For office use only.)