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Arkansas Secretary of State
1401 W.Capitol, Suite 250, Little Rock, AR 72201
John Thurston 501-682-3409 • www.sos.arkansas.gov
Application for Amended Certificate of Registration
by Foreign Limited Liability Company
(Please type or print)
FILL IN COMPLETELY
The undersigned, pursuant to Act 1041 of 2021, sets forth the following:
1. is a Foreign Limited Liability Company
authorized to transact business within the State of Arkansas.
2. Date original Application for Registration filed in Arkansas:
3. The Amendment to the Application for Registration is:
I affirm that I am the individual authorized to sign on behalf of the aforementioned entity to be formed and that,
under penalty of perjury, the information stated in this record is accurate.
_______________________________________________________________________
Signature
_______________________________________________________________________
Name
_______________________________________________________________________
Title
Fee: $300.00 payable to Arkansas Secretary of State FL-02 Rev. 8/21
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