Limited Liability Company

Contact Information

Name

First Last

Email*

Enter Email Confirm Email

Phone*

Do you already have a UBI Number? (Check one)

Yes
No

If No, a new UBI# will be issued to you upon successful completion of the filing.

If Yes, provide UBI #

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. Limited Liability Company name must contain the words Limited Liability Company, Limited Liability Co., or the abbreviation of L.L.C. or LLC. If the designation is omitted, it will default to LLC when processed.

1st Choice

2nd Choice

3rd Choice

Does the entity have a name reserved?

Yes
No

If Yes, provide the Name Reservation Number and Name

Name Reserved

PERIOD OF DURATION : Please check ONE of the following

This Company shall have a perpetual duration
This Company shall have a duration of
This Company shall expire on

How many years

Expiration date

EFFECTIVE DATE: Please check ONE of the following:

Date of filing
Specific Date

Date

Is the Registered Agent a Commercial Registered Agent?

Yes
No

A Commercial Registered Agent is an entity or individual that is registered with the Office of the Secretary of State to receive legal documents on behalf of a corporation. A Commercial Registered Agent has the entities/individual’s address on record with the office. A Registered Agent consent is still required for a Commercial Registered Agent located below. If No, please continue below

If Yes, provide the name of the Commercial Registered Agent:

If No, please continue below

Please complete ONE type of Registered Agent below. Be sure to include the name below the checked box. Then continue to provide the required street address. Mailing address if needed.

Individual
Entity
Office or Position

Individual

First and last name of a Non-commercial Registered Agent. (Any person not registered as a Commercial Registered Agent.)

Entity

Name of a Non-commercial Registered Agent. (Any business not registered as a Commercial Registered Agent.)

Office or Position

List the Office or Position serves as agent. (Only if using the specific office or position as the registered agent, no matter who holds the position like: Secretary, Member or Treasurer.)

Phone

Email

Registered Agent Street Address (required) (Must be a physical address No PO Box or PMB)

Street Address City State ZIP Code

Registered Agent Mailing Address (optional)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

PRINCIPAL OFFICE: *The place where the entity’s records are kept

Principal Office Street Address (Must be a physical address; No PO Box or PMB)

Street Address City State / Province / Region ZIP / Postal Code Country

Mailing Address (optional)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone: (optional)

Email: (optional)

RETURN ADDRESS FOR THIS FILING: (Optional)

Attention to:

Email

This address will be sent document(s) regarding this specific filing in addition to document(s) being sent to the Registered Agent’s street/mailing address.

Street Address Address Line 2 City State ZIP Code

EXECUTOR INFORMATION:

Name, address, and signature required. Attach additional sheets if necessary. I herby certify, under penalty of law, that the above information is accurate and complies with the filing requirements of state law.

Name:

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Printed Name/Title

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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By clicking submit you agree to these Terms and Conditions and the above authorization of payment.