Free Registration Statement - Wyoming

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: [email protected]

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:

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:
(mm/dd/yyyy)

Signature: ___________________________________________ Print Name: Title:

Date:
(mm/dd/yyyy)

Signature: ___________________________________________ Print Name: Title:

Date:
(mm/dd/yyyy)

Signature: ___________________________________________ 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

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: [email protected]

Consent to Appointment By Registered Agent
I,
(name of registered agent)

, registered office located at

(registered office address, city, state & zip)

voluntarily consent to serve as the registered agent for

(name of business entity)

on the date shown below.

I hereby certify that I am in compliance with the requirements of W.S. 17-28-101 through W.S. 17-28-111.

Signature:__________________________________________
(Shall be executed by the registered agent.)

Date:
(mm/dd/yyyy)

Print Name: Title:

Contact Person: Daytime Phone: Email:

Checklist Submit one originally signed consent to appointment and one exact photocopy.

RAConsent ­ Revised 06/16/2009