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                                     STATE OF LOUISIANA                                                    Commercial Division    
                                                                                                           (225) 925-4704
                                     SECRETARY OF STATE
 R. Kyle Ardoin                                                                                            Fax Numbers 
Secretary of State                                                                                         (225) 932-5314 Corporations
                                                                                                           (225) 932-5317 Legal Services
                                                                                                           (225) 932-5318 UCC

                            TRANSMITTAL INFORMATION
                            For All Business Filings

Business Name (List  exactly  as it appears in documents)

Name of person filing document (evidence of filing will be mailed to this person, at address below)

Address

City                                  State                                                        Zip Code

Daytime phone number                 Fax number                                                    Email address

NOTE:  Louisiana Law requires all Louisiana notaries to print or type their name and notary or 
             bar roll number on the document.

                     Mailing Address: P.O. Box 94125, Baton Rouge, LA 70804-9125 
                     Physical Address: 8585 Archives Ave., Baton Rouge, LA 70809         
                                                         www.sos.la.gov

 SS984  Rev. 05/18

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STATE OFLOUISIANA

SECRETARY OF S TATE
R. Kyle Ardoin Commercial Division
Secretary of State (225) 925-4704
Fax Numbers
(225) 932-5317 Administrative Services
(225) 932-5314 Corporations
(225) 922-0452 UCC

IMPORTANT NOTICE

The instructions from the Secretary of State’s O ffice in order to qualify a foreign limited
liability company to do business in the State of Louisiana are the following:

1. The name must be identical to the name on certificate of existence or good standing from organizing
jurisdiction. The certificate must be dated within 90 days of its submission. (In the states of Texas
and Alabama, obtain a certificate of existence from the secretary of state, not a good standing from
the Comptroller/Department of Revenue.)

2. The name must be identical to the name on the certificate of fact evidencing the name change
issued by the proper official of the organizing jurisdiction.

3. The date organized in your state or country and period of duration, if any.

4. The street address of the principal office of the organization in the state or country under the laws of
which it is organized.

5. The street address or intended street address of its principal business office wherever located. If you
do not have one, write none in this space.

6. The address of the principal business establishment in this state.

7. This address shall be the street address of your registered agent if the agent is an individual or
corporation.

8. The agent must be an individual resident in Louisiana, an individual attorney or a partnership which
is authorized to practice law in Louisiana or a domestic or foreign corporation authorized to act as
registered agent for other organizations.

9. The nature of business that the limited liability company proposes to transact in this state and a
statement that it is empowered to transact such business under the laws under which it is organized.

NOTE: If the company includes in its name the words "engineer, " " engineering, " " surveyor ,"or
"surveying," please contact the Louisiana Professional Engineering and Land Surveying Board prior to
submitting the application for authority. They can be contacted by phone at (225) 925-6291, by mail at
9643 Brookline Ave., Suite 121, Baton Rouge, LA 70809 orwww.lapels.com.

10. The name and addresses of the company's members and managers. Attached addendum if needed for
additional members and managers.

Mailing Address: P. O. Box 94125, Baton Rouge, LA 70804-9125
Physical Address: 8585 Archives Ave., Baton Rouge, LA 70809
SS971 Rev. 05/18 www sos la.gov

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R. Kyle Ardoin APPLICATION FOR AUTHORITY
Secretary of State TO TRANSACT BUSINESS IN LOUISIANA
(R.S. 12:1345)
Foreign Limited Liability Company Return to: Commercial Division
Enclose $150 filing fee P. O. Box 94125
Make remittance payable to Baton Rouge, LA 70804-9125
Secretary of State (225) 925-4704
Do Not Send Cash www.sos.la.gov
STATE OF Check one: ( ) Non Profit Check one: ( ) Original Application
( ) Business ( ) Amended Application
PARISH/COUNTY OF
1. Limited liability company name:
2. Previous name:

3. Date of organization: Period of duration:

4. Principal office address in state or country of organization:

5. Principal business office address:
PLEASE INCLUDE COMPLETE STREET ADDRESSES FOR THE FOLLOWING
6. Principal business establishment in Louisiana:

7. Registered office address in Louisiana:

8. Registered agent’s name and address in Louisiana:

9. Nature of business to be transacted in Louisiana:

10. Names and addresses of members and managers:

To be signed by a Member/Manager Title and Date

Sworn to and subscribed before me, the undersigned Notary Public, on this date:

Notary
AGENT’S ACCEPTANCE AND ACKNOWLEDGEMENT OF APPOINTMENT
I hereby acknowledge and accept the appointment of registered agent for and on behalf of the above named corporation.

Registered Agent
Sworn to and subscribed before me on this date:

Notary
SS972 Rev. 05/18

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