Enlarge image | Clear Form Print Form DO NOT WRITE ABOVE THIS LINE; RESERVED FOR ACC USE ONLY. STATEMENT OF CORRECTION LIMITED LIABILITY COMPANY Read the Instructions L030i 1. ENTITY NAME – give the exact name in Arizona of the LLC as currently shown in A.C.C. records: __________________________________________________________________________________________________ 2. DOCUMENT BEING CORRECTED – provide the information below for the document being corrected OR check this box and attach a copy of the defective document. 2.1 Document name or title: __________________________________________________________________ 2.2 Document ID # (bar code number): __________________________________________________________ 3. DATE DOCUMENT WAS FILED (DATE RECEIVED): _________________________________________________ 4. INCORRECT STATEMENT OR DEFECTIVE EXECUTION – print the exact incorrect statement below or describe how the filing was defectively signed. 5. EXPLANATION - briefly explain or describe how or why the statement is incorrect or how or why the execution, attestation, verification or acknowledgement is defective: 6. CORRECT STATEMENT OR EXECUTION - print the exact correct statement below or describe the correct execution, attestation, verification or acknowledgement: SIGNATURE: By checking the box marked "I accept" below, I acknowledge under penalty of law that this document together with any attachments is submitted in compliance with Arizona law. I ACCEPT Signature Printed Name Date REQUIRED – check only one and fill in the corresponding blank if signing for an entity: I am an individual authorized to sign this document. I am signing on behalf of an entity that is authorized to sign this document. Expedited or Same Day/Next Day services are available for an additional fee – see Instructions or Cover sheet for prices. Filing Fee: $25.00 (regular processing) Mail: Arizona Corporation Commission - Examination Section 1300 W. Washington St., Phoenix, Arizona 85007 All fees are nonrefundable - see Instructions. Fax: 602-542-4100 Please be advised that A.C.C. forms reflect only the minimum provisions required by statute. You should seek private legal counsel for those matters that may pertain to the individual needs of your business. All documents filed with the Arizona Corporation Commission are public record and are open for public inspection. If you have questions after reading the Instructions, please call 602-542-3026 or (within Arizona only) 800-345-5819. L030.004 Arizona Corporation Commission – Corporations Division Rev: 3/2020 Page 1 of 1 |