Professional Limited Liability Company

Contact Information

Name*

First Last

Email*

Enter Email Confirm Email

Phone*

1. ENTITY TYPE

PROFESSIONAL LIMITED LIABILITY COMPANY (entity name must contain the words "Professional Limited Liability Company", "PLLC" or "PLC")

2. ENTITY NAME – Please provide 3 choices for the name, in order of preference, so in the event your preferred choice is not available we can proceed with your next choice. (The name shall contain the words “Limited Liability Company” or “Limited Company” or the abbreviations “L.L.C.”, “L.C.”, “LLC”, “LC” , "PLLC" or "PLC")

2nd Choice

3rd Choice

3. PROFESSIONAL LIMITED LIABILITY COMPANY SERVICES

if and only if professional LLC is checked in number 1 above, describe the professional services that the professional LLC will provide (examples: law firm, accounting, medical):

4. STATUTORY AGENT for service of process

4.1 REQUIRED – give the name (can be an Arizona resident or an Arizona-registered entity) and physical or street address (not a P.O. Box) in Arizona of the statutory agent:

Statutory Agent Name

Statutory Agent Name Last

Attention (optional)

Name

Physical Address

Street Address Address Line 2 City State ZIP Code

Attention (optional)

Name

4.2 REQUIRED – mailing address in Arizona of Statutory Agent (can be a P.O. Box):

Check box if same as physical/street address.

Mailing Address

Address 1 Address 2 (optional) City State Zip

5. PRINCIPAL ADDRESS:
The principal address is not required to be an Arizona address and it can be the same as the statutory agent’s street address.

5.1 Is the principal address the same as the street address of the statutory agent?

Yes – go to number 6 and continue
No go to number 5.2 and continue

5.2 Attention (optional) if 5.1 is "No"

Name

5.2 Principal Address

Address 1 Address 2 (optional) City Country State or Province Zip Country

COMPLETE NUMBER 6 OR NUMBER 7 – NOT BOTH.

6. MANAGER-MANAGED LLC

Management of the LLC will be vested in a manager or managers (meaning one or more managers will run the company).

7. MEMBER-MANAGED LLC

Management of the LLC will be reserved to the members (meaning all members will run the company together if there is no operating agreement stating otherwise).

Application Fee

Price:

Please select an additional service that you wish to have processed

Priority Request / Rush Processing + $75

Total

$0.00

Consent

I agree

I CERTIFY THAT THE RECITATIONS CONCERNING THE VESSEL: NAME, TONNAGE, DIMENSIONS, PROPULSION, OWNERSHIP, HAILING PORT, RESTRICTIONS, ENTITLEMENTS, REMARKS AND ENDORSEMENTS CONTAINED IN THE CERTIFICATE OF DOCUMENTATION REMAIN ABSOLUTELY THE SAME.

NAME:*

Type your full name to sign this secure webform

Signature*

CAPACITY OF PERSON SIGNING (E.G., AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)

Authorization*

I agree

I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected applications. I understand that my application will be processed in the order in which it is received by Corporation Center, a private fee-for-service company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Corporation Center’s no refund policy.

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