Secretary of State Office 
500 E Capitol Ave            QUALIFICATION FOR FARMING 
Pierre, SD 57501                       DOMESTIC LIMITED  IABILITY L             OMPANYC  
                                                     SDCL 47-9A 
(605)773-4845
corpinfo@state.sd.us
                                            Please Type or Print Clearly in Ink 

                                                NO FILING FEE 

1. The Name and Business ID of the company is:

   Name (Note: This must be the exact limited liability company name as registered.)          Business ID 

2. The name of the state or other jurisdiction under whose laws it is organized:              South Dakota 

3. The South Dakota Registered Agent’s name

   South Dakota law permits the registered agent to be either: A) noncommercial registered agent (this may be an
   individual) or B) a commercial registered agent.  Complete only one below, either (a) or (b).

   (a)  The South Dakota Noncommercial Registered Agent’s name

   Actual Street Address in this State                                        City                  State  ZIP+4 

   Mailing Address in this State, if Different from Street Address            City                  State  ZIP+4 
    _____________________________________________________________________________________________________________________ 
   Email Address (Optional)  

   (b)  When listing a Commercial Registered Agent, please state their CRA#. This number can be obtained from the
        Commercial Registered Agent.

   Commercial Registered Agent Name                                                                 CRA# 

4. List the acreage and location by section, township and county of each lot or parcel of land in this state owned or leased
   by the Limited Liability Company and used for the growing of crops or the keeping or feeding of poultry or livestock (You
   may add additional pages if necessary).

   Acres                     Section                                                 Township              County 

   Acres                     Section                                                 Township              County 

   Acres                     Section                                                 Township              County
                                                                                                                  
   Acres                     Section                                                 Township              County
                                                                                                                  
5. Is the majority of the voting stock held by members of a family, an estate of a family member, or a trust that benefits
   members of the family?
                                        Yes No      

                                                                   Page  1 of 2 

 6. Is at least one of the stockholders: 
         (a) a person residing on the farm?                        Yes       No 
         (b) a person actively operating the farm?                 Yes       No 
         (c) a person who has resided on the farm?                 Yes       No 
         (d) a person who has actively operated the farm?          Yes       No 
 
 7. State the number of shares owned by persons residing on the farm or actively engaged in farming or their relatives within 
    the third degree of kindred (You may add additional pages if necessary). 
    
    Name                        Address              City          State        Zip             Shares    DOK 
                                                                                                           
    Name                        Address              City          State        Zip             Shares    DOK 
     
    Name                        Address              City          State        Zip             Shares    DOK 
                                                                                                 
    Name                        Address              City          State        Zip             Shares    DOK 
                                                                                                           
    Name                        Address              City          State        Zip             Shares    DOK 
    
 8. Are all the shareholders either natural persons, estates of a family member, or a trust that benefits members of the 
    family?     
                                Yes         No       
  
 9. The percentage of gross receipts of the Limited Liability Company derived from rent, royalties, dividends, interest, and 
    annuities:  
                                _____% 
      
 10. State the number of shareholders.  _____ 
  
 11. Is there more than one class of stock?    Yes        No 
  
 12. As to each shareholder state the name, address, number of shares owned, and degree of kindred (DOK). 
  
    Name                        Address              City          State        Zip             Shares    DOK 
     
    Name                        Address              City          State        Zip             Shares    DOK 
     
    Name                        Address              City          State        Zip             Shares    DOK 
  
 No person may execute this report knowing it is false in any material respect. Any violation may be subject to a criminal 
 penalty (SDCL 22-39-36). 
  
 Dated                                                                                                                      
                                                              Signature of an authorized person 
  
 Email                                                                                                                      
      (Optional)                                              Printed Name 
 
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                                                                                                Domesticllcfarmqualification March 2017