Limited Liability Company

Return document by:

mail
email

Email

Name

First Last

Address

Street Address City State ZIP Code

Check if applicable

I qualify for a veteran/reservist-owned small business fee exemption

The name of the limited liability company is:

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. Designator is required, e.g., “company,” “limited” or “limited liability company” or any abbreviation thereof.

1st Choice*

2nd Choice

3rd Choice

Complete part (a) or (b) – not both:

(a) Address (No P.O box)

The address of this limited liability company’s registered office in this Commonwealth is:

Street Address County City State ZIP Code

(b) The name of this limited liability company’s commercial registered office provider

(b) County of venue

The name of each organizer

Name

First Last

Name

First Last

Name

First Last

Effective date of Certificate of Organization

Effective upon filing in the Department of State
Effecting on the following date:

Date

Time

:

Restricted professional companies only

The company is a restricted professional company organized to render the following restricted professional service(s):

Benefit companies only

Check the box immediately below if the limited liability company is organized as a benefit company:

This limited liability company shall have the purpose of creating general public benefit.
This limited liability company shall have the purpose of creating the enumerated specific public benefit(s):

List of Benefits

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

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.

Credit Card

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