Free RETURN TO - South Dakota

Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845

ANNUAL FARM REPORT
Limited Liability Company
Please Type or Print Clearly in Ink No Filing Fee

FILE DATE

____________________

RECEIPT NO ___________________

Clear Form
HELP
Telephone # ____________________ FAX # _______________________

1. L.L.C. Name and Address:

Search for Corporate ID, Name and Agent

FILING DATE: To be filed with the Annual Report.

2. 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

3. List only the changes since the last report of the acreage and location by section, township and county of each lot or parcel of land in this state owned or leased by the Limited Liability Company. _______________________________________________________________________________________________
County Section Township Acres

_______________________________________________________________________________________________
County Section Township Acres

_______________________________________________________________________________________________
County Section Township Acres

4. Please complete the appropriate section: Family Farm Corporation The NUMBER OF MEMBERSHIP INTERESTS owned by person(s) residing on the farm or actively operating the farm, or who has resided on or has actively operated the farm, or their relatives within the third degree of kindred, or by resident stockholders who are family farmers and are actively engaged in farming as their primary economic activity. The PERCENTAGE of gross receipts of the company derived from rent, royalties, dividends, interest and annuities.

________________

Authorized Farm Corporation

______________%

5. List changes only of names, address and number of membership interests owned by shareholders. ________________________________________________________________________________________________
Name Address City State Zip Shares Kindred

________________________________________________________________________________________________
Name Address City State Zip Shares Kindred

________________________________________________________________________________________________
Name Address City State Zip Shares Kindred

Dated ____________________________

______________________________________________
(Signature of an authorized officer)

______________________________________________
(Printed Name)

______________________________________________
(Title) llcfarmreport July 2009