Free RETURN TO - South Dakota

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

QUALIFICATION FOR FARMING
LIMITED LIABILITY COMPANY
Please Type or Print Clearly in Ink No Filing Fee

Clear Form

HELP

Telephone # ____________________ FAX # _______________________

1. The name of the Limited Liability Company is __________________________________________________________ ______________________________________________________________________________________________ 2. The state of organization ___________________________________ 3. The South Dakota Registered Agent name ___________________________________________________________ ______________________________________________________________________________________________
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

4. List 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 and used for the growing of crops or the keeping or feeding of poultry or livestock: _______________________________________________________________________________________________
County Section Township Acres

_______________________________________________________________________________________________
County Section Township Acres

_______________________________________________________________________________________________
County Section Township Acres

_______________________________________________________________________________________________
County Section Township Acres

5. The names, addresses and title of the members and/or manager(s). Please place a check mark next to the name if the person is a manager. _____________________________________________________________________________________________
Name Street Address City State ZIP+4

_____________________________________________________________________________________________
Name Street Address City State ZIP+4

_____________________________________________________________________________________________
Name Street Address City State ZIP+4

_____________________________________________________________________________________________
Name Street Address City State ZIP+4

_____________________________________________________________________________________________
Name Street Address City State ZIP+4

_____________________________________________________________________________________________
Name Street Address City State ZIP+4

6. Please check which applies to this Limited Liability Company: This is a Family Farm This is an Authorized Farm 7. Please complete the appropriate section: Family Farm 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.
Note: Degree of kindred is defined as the number of generations with each

generation being a degree (SDCL 23A-20-30 Authorized Farm The PERCENTAGE of gross receipts of the company derived from rent, royalties, dividends, interest and annuities. Note: Percentage amount cannot exceed 20% of its gross receipts.

_______________

______________%

8. The name, address and number of membership interests owned by each member ________________________________________________________________________________________________
Name Address City State Zip Shares Kindred

________________________________________________________________________________________________
Name Address City State Zip Shares Kindred

________________________________________________________________________________________________
Name Address City State Zip Shares Kindred

________________________________________________________________________________________________
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) Llcfarmqualification 2008