Delaware Division of Corporations 
                     401 Federal Street – Suite 4 
                      Dover, DE 19901 
                     Ph: 302-739-3073 
                     
                                                  Certificate of Formation 
                                               of a Limited Liability Company 
                                                                         
Dear Sir or Madam:  
 
       Enclosed please find a form for a Certificate of Formation of a Limited Liability 
Company to be filed in accordance with Section 18-201 of the Limited Liability Company 
Act of the State of Delaware. The fee to file the Certificate is $90.  You will receive a 
stamped “Filed” copy of the submitted document. A certified copy may be requested for an 
additional $50. Expedited services are available. Please contact our office concerning these 
fees or you may consult our fee chart at www.corp.delaware.gov.  Please make the check 
payable to “Delaware Secretary of State”.  
 
       Annual Taxes in the amount of $300 for the limited liability company are due by 
June 1 of each year following the calendar year in which their Certificate of Formation 
becomes effective.  Please contact the Franchise Tax Section with any questions regarding 
Annual Taxes.  
 
       For the convenience of processing your order in a timely manner, please include a 
cover letter with your name, address and telephone/fax number to enable us to contact you if 
necessary. Please make sure you thoroughly complete all information requested on this form. 
It is important that the execution be legible, we request that you print or type the name of 
the person signing under the signature line.  
 
       Thank you for choosing Delaware as your corporate home. Should you require 
further assistance in this or any other matter, please don’t hesitate to call us at (302) 739-
3073.  
 
                                               Sincerely,  
 
                                               Department of State  
                                               Division of Corporations 
 encl. 
 rev. 10/16 
 

Special Instructions – Certificate of Formation of a Limited 
Liability Company 
 
This form is to be used as a Template only. The following 
instructions will help you in correctly completing your Formation 
Certificate. The instructions are numbered to correspond with the 
article being referenced. 
 
 1.  The name of the limited liability company exactly as you 
  wish it to appear in our records.  Please visit our website to 
  verify the availability of the name.  The name must include 
  the words “Limited Liability Company” or the abbreviation 
  “L.L.C.” or the designation “LLC”. 
   
 2.  List the name and address of the registered agent located in 
  Delaware you are appointing to accept service of process for 
  the limited liability company.   
  
 Execution Block - The document must be signed by an 
  authorized person of the limited liability company pursuant 
  to Section 18-204 of Title 6, Chapter 18.  The name of the 
  person must be typed or written legibly underneath the 
  signature. 
  
This form contains information required by statute; if you need to 
add additional information permitted by statute you may draft a 
new document.  Please feel free to call our office at 302-739-3073 
for assistance in completing this form. 
 
Sincerely, 
 
Delaware Division of Corporations 

         STATE OF DELAWARE 
         CERTIFICATE OF FORMATION 
         OF LIMITED LIABILITY COMPANY 
 
The undersigned authorized person, desiring to form a limited liability company pursuant 
to the Limited Liability Company Act of the State of Delaware, hereby certifies as 
follows: 
 
1.   The name of the limited liability company is______________________________ 
_______________________________________________________________________ . 
 
2.   The Registered Office of the limited liability company in the State of Delaware is 
located at _________________________________________________________(street), 
in the City of ____________________________, Zip Code__________________.  The 
name of the Registered Agent at such address upon whom process against this limited 
liability company may be served  is___________________________________________ 
_______________________________________________________________________. 
 
          By:____________________________________ 
                  Authorized Person 
          
          Name:____________________________________ 
          Print or Type