State of New Hampshire 

     APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY 
                INSTRUCTIONS FOR COMPLETING FORM FLLC-1 (RSA 304-C:175) 

1. The form must be legibly printed or typed on 8.5” x 11” paper and maintain 1” margins.  Pencil or
   erasable ink is not acceptable.

2. Article First:  The EXACT name of the limited liability company as registered by the Secretary of
   State from the state or country of formation.  The name must match exactly as on record including
   punctuation wherever it appears on the Form FLLC-1 application.

3. Article Second:  If the name of the limited liability company does not contain the words “Limited
   Liability Company”, the abbreviation “L.L.C.” or similar abbreviation, insert the name of the limited
   liability company with the words “Limited Liability Company”, the abbreviation “L.L.C.” or similar
   abbreviation.
   OR
   If the limited liability company name is not available for use in New Hampshire, enter the name to be
   used in New Hampshire.  In this case, a trade name application must be filed with an additional
   $50.00 fee.

4. Principal business information is optional and is not part of article second.  The registered agent
   address will be used as the principal office address if no principal office address is listed.

5. Articles Third & Fourth:  State or country of formation and date formed in that state or country.

6. Article Fifth:  A brief description of the type of business (e.g. real estate, hairdresser, etc.) must be 
   listed.  Refer to RSA 304-C:21 for nature of business permitted.

7. Article Sixth:  Per RSA 304-C:177 IV, a registered agent and registered office must be provided.
   The registered agent must reside in New Hampshire.  The registered agent is the person who would
   receive service of process should the corporation be sued.  The registered office is the registered
   agent’s business address where the registered agent can be found for in-hand service of process.  A
   street/physical address must be provided.  Your application will not be processed without an
   agent named or if an out of state address is listed.

8. Shall be executed on behalf of the foreign limited liability company by a person with authority to do so
   under the laws of the state or other jurisdiction of its formation, or, if the foreign limited liability
   company is in the hands of a receiver, executor, or other court appointed fiduciary, trustee, or other
   fiduciary, it must be signed by that fiduciary.

9. The total filing fee to register is $100.00, payable to the State of New Hampshire.

PLEASE NOTE:  The name will be searched for availability upon receipt of these documents.  If the filing 
has been accepted, you will receive a filed-stamped copy within 30 days.  If you do not receive an 
acknowledgement, please contact our office.  Checks are deposited upon receipt.  If the check has been 
cashed, it only indicates we have received the document.  A cashed check is not an indication that the 
document has been accepted and filed. Please call the Corporation Division (603-271-3246) with any 
questions you may have regarding this application. 

Mailing Address - Corporation Division, NH Dept. of State, 107 N Main St, Rm 204, Concord, NH 03301-4989 
            Physical Location - State House Annex, 3rd Floor, Rm 317, 25 Capitol St, Concord, NH 
                                                                                      Form FLLC-1  Instruct. 

To print a blank copy of this form, press Ctrl + P.

Print Reset
                         State of New Hampshire 
 
Filing fee:  $100.00                                                                 Form FLLC-1 
Use black print or type.                                                             RSA 304-C:175 
 
                              APPLICATION FOR REGISTRATION AS A 
                                                   FOREIGN LIMITED LIABILITY COMPANY 
 
PURSUANT TO THE PROVISIONS of the New Hampshire Limited Liability Company laws, the 
undersigned hereby applies for registration to transact business in New Hampshire and for that purpose 
submits the following statement: 
 
FIRST:  The name of the limited liability company is                                                    
                                                                                                       . 
 
SECOND:  The name which it proposes to register and do business in New Hampshire is                     
                                                                                                        
                                                                                                       . 
                                                   Principal Business Information: 
  Principal Office Address:                                                                             
                              (no. & street)                             (city/town) (state) (zip code) 
  Principal Mailing Address (if different):                                                             
                                                   (no. & street)        (city/town) (state) (zip code) 
  Business Phone:                                                        
  Business Email:                                                        
  ____ Please check if you would prefer to receive the courtesy Annual Report Reminder by email. 
 
THIRD:  It is formed under the laws of                                             . 
 
FOURTH:  The date of its formation is                              . 
 
FIFTH:  Describe the nature of the business or purposes to be conducted or promoted in New Hampshire 
(and if known, list the NAICS Code and Sub Code):                                                       
                                                                                                        
                                                                                                       . 
 
SIXTH:  The name of its registered agent           in New Hampshire is: 
                                                                                                       . 
The complete address of its registered office IN NEW HAMPSHIRE (agent's business address) is: 
                                                                                                       . 
      (no. & street)                                                     (city/town) (state) (zip code) 
 
                                                   Page 1 of 2 
                                                                                             Form FLLC-1 

APPLICATION FOR REGISTRATION AS A                                                                Form FLLC-1 
FOREIGN LIMITED LIABILITY COMPANY                                                                          (Cont.) 

                                 MANAGER / MEMBER INFORMATION 
                 (List all Managers and/or Members you wish to be placed on record) 
  NAME                                    BUSINESS ADDRESS                                       TITLE 

                                          *Signature:
                                 Print or type name:  
                                                         Title:  
                                          Date signed:  

                 Complete address of person signing: 

Note:  The sale or offer for sale of membership interests of the limited liability company will comply with 
the requirements of the New Hampshire Uniform Securities Act (RSA 421-B).  The membership interests 
of the limited liability company:  1) have been registered or when offered will be registered under RSA 
421-B; 2) are exempted or when offered will be exempted under RSA 421-B; 3) are or will be offered in a 
transaction exempted from registration under RSA 421-B; 4) are not securities under RSA 421-B; OR 5) 
are federal covered securities under RSA 421-B.  The statement above shall not by itself constitute a 
registration or a notice of exemption from registration of securities within the meaning of sections 448 and 
461(i)(3) of the United States Internal Revenue Code and the regulation promulgated thereunder. 

* Shall be executed on behalf of the foreign limited liability company by a person with authority to do so under the
  laws of the state or other jurisdiction of its formation, or, if the foreign limited liability company is in the hands of a
  receiver, executor, or other court appointed fiduciary, trustee, or other fiduciary, it must be signed by that fiduciary.

DISCLAIMER:  All documents filed with the Corporation Division become public records and will be available for 
public inspection in either tangible or electronic form. 

Mailing Address - Corporation Division, NH Dept. of State, 107 N Main St, Rm 204, Concord, NH 03301-4989 
  Physical Location - State House Annex, 3rd Floor, Rm 317, 25 Capitol St, Concord, NH 

                                          Page 2 of 2 
                                                                                         Form FLLC-1  (10/2018)