PDF document
- 1 -

Enlarge image
www.BusinessRegistrations.com                                                                                                    FORM FLLC-1 
Nonrefundable Filing Fee: $50.00                                                                                                                   7/2012

                                                   STATE OF HAWAII 
                                 DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS                                                     *FLLC1*
    Clear Form
                                            Business Registration Division 
                                                   335 Merchant Street 
                                 Mailing Address:  P.O. Box 40, Honolulu, Hawaii 96810 
                                                   Phone No. (808) 586-2727 
                                                                 
                                 APPLICATION FOR CERTIFICATE OF AUTHORITY 
                                 FOR FOREIGN LIMITED LIABILITY COMPANY 
                                            (Section 428-1002, Hawaii Revised Statutes) 
                                                                
PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK

The undersigned, in accordance with the provisions of the Hawaii Uniform Limited Liability Company Act, certify as follows: 
 
 1. The name of the limited liability company is:

                                  (Name must be exactly as stated on Certificate of Existence including spacing and punctuation) 
     
 2. Its state or country of organization is:

 3. The mailing address of its principal office is:

 4. A list of the names and addresses of all members and their respective capital contributions are kept and will be kept at 
    this principal office until this registration is cancelled.

 5. The company shall have and continuously maintain in the State of Hawaii a registered agent who shall have a business 
    address in this State.  The agent may be an individual who resides in this State, a domestic entity or a foreign entity 
    authorized to transact business in this State.

    a. The name (and state or country of incorporation, formation or organization, if applicable) of the company's  
       registered agent in the State of Hawaii is:

                                            (Name of Registered Agent)                                                           (State or Country)

    b. The street address of the place of business of the person in State of Hawaii to which service of process and other 
       notice and documents being served on or sent to the entity represented by it may be delivered to is:

 6. The period of duration is (check one):

       At-will

       For a specified term to expire on:
                                                   (Month)             (Day)            (Year)



- 2 -

Enlarge image
                                                                                                                     FORM FLLC-1 
                                                                                                                              7/2012

7. The company is (check one):
   a.            Manager-managed, and the names and addresses of each manager is listed in paragraph ā€œcā€.

   b.            Member-managed, and the names and addresses of each member is listed in paragraph ā€œcā€.

   c.       List the names and addresses of each manager if the company is Manager-managed, or 
            List the names and addresses of each member if the company is Member-managed.

8. The members of the company (check one):

            Shall not be liable for the debts, obligations and liabilities of the company.

            Shall be liable for all debts, obligations and liabilities of the company.

            Shall be liable for specified debts, obligations and liabilities of the company as stated below, and have consented in 
            writing to the adoption of this provision or to be bound by this provision.

9. Attached is an original certificate of existence or a record of similar import, authenticated by the proper government official 
   having custody of the company records in the state or country under whose laws it is organized, and dated not more than 
   sixty (60) days prior to the filing of this application.  If the certificate is in a foreign language, a translation under oath of the 
   translator is attached.

I/we certify under the penalties set forth in the Hawaii Uniform Limited Liability Company Act, that I/we have read the above 
statements, I/we are authorized to sign this application, and that the above statements are true and correct.

Signed this          day of                                                  ,

                     (Type/Print Name & Title)                                              (Type/Print Name & Title)

                     (Signature)                                                            (Signature)

SEE INSTRUCTIONS PAGE. The application must be signed and certified by at least one manager of a manager-managed 
company, by at least one member of a member-managed company or by a person who is authorized or required to sign a 
record under the laws of its jurisdiction of organization.






PDF file checksum: 2450583853

(Plugin #1/10.13/13.0)