This form must be type written or computer generated.
            State of Utah 
            Department of Commerce 
            Division of Corporations & Commercial Code 
            Foreign   Registration Statement (Foreign Limited Liability Company) 
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Instructions
Important:  Read instructions before completing form                                                              Non-Refundable Processing Fee: $54.00         
1. Exact Name of Foreign Limited Liability Company:
2. Jurisdiction of Formation:
3. Principal office address:
     Street Address Required             ____________________________________________________________________________________________________ 
                                         Address                                                        City                             State           Zip
4. The name of the Registered Agent (Individual or Business Entity or Commercial Registered Agent):
__________________________________________________________________________________________ 
The address must be listed if you have a non-commercial registered agent.  See instructions for further details.  
Address of the Registered Agent: _____________________________________________________________ 
                                         Utah Street Address Required, PO Boxes can be listed after the Street Address 
City:                                                                                                              State  UT         Zip:
5. If the name is not available in Utah the LLC shall use as it’s name:
______________________________________________________________________________ 
                                         Must be the same as number (1) unless the name is not available or permitted in Utah. 
6. Purpose of the Limited Liability Company:
   (optional)
7. Managers/Members of the Limited Liability Company:
   (optional)
Position            Name                 Address                                                                   City                          State      Zip
MANAGER:
MANAGER:
MEMBER:
MEMBER:
Under penalties of perjury, I declare that this application for authority to transact business has been examined by me and is, to the best of my knowledge and belief, 
true, correct and complete. 
Authorized Signature:                                                           Name & Title:
Under GRAMA {63G-2-201}, all registration information maintained by the Division is classified as public record.  For confidentiality purposes, you may 
use the business entity physical address rather than the residential or private address of any individual affiliated with the entity. 

08/23