State of Alaska 
                           Division of Corporations, Business and Professional Licensing 
                           CORPORATIONS SECTION 
                           PO Box 110806 
                           Juneau, AK  99811-0806 
                           Phone: (907) 465-2550 
                           Fax: (907) 465-2974 
                           Website: www.commerce.alaska.gov/occ 
                                                             
                           CERTIFICATE OF REGISTRATION 
                              Foreign Limited Liability Company 
                                               AS 10.50.615 
 Filing Fee: $350.00    
  
 INSTRUCTIONS (Please retain for your records): 
  
 Refer to Alaska Statutes 10.50.615. If you need assistance in completing your filing, it is advised that 
 you seek legal counsel. Please be aware that this filing will become public information. 
  
 ITEM 1: Legal Name of the Limited Liability Company 
 The name of the limited liability company must contain the words “limited liability company” or the abbreviation 
 “L.L.C.,” or “LLC”.  The word “limited” may be abbreviated as “Ltd.,” and the word “company” may be 
 abbreviated as “Co.”  The name of a city, borough, or village may be used in a limited liability company name; 
 however, the name may not contain the word “city,” “borough,” or “village” or otherwise imply that the company 
 is a municipality. A company name must be distinguishable upon the record. To search the availability of the 
 legal name of the company in the State of Alaska go to the Corporations Section at 
 www.commerce.alaska.gov/occ and select Search Corporations Database.  
  
 The entity must be in good standing in their state of domicile, before we can issue a certificate of authority, 
 please check the box.  
  
 ITEM 2: Assumed Name 
 The name the company elects to use if the legal name is already in use by another entity in Alaska.  
  
 ITEM 3: State of Domicile, Date of Incorporation, Duration 
 Indicate the state of domicile, or “home state”, and the date of organization in the state of domicile 
 (mm/dd/yyyy) format. Duration is the life expectancy of the limited liability company and may be a specific 
 future date of less than 100 years. If there is no expected end date, select the “perpetual” box, indicating the 
 limited liability company’s plans to transact business uninterrupted for an undeterminable amount of time. 
  
 ITEM 4: Disclosure of Corporate Purposes 
 The purpose describes activities of the company at the time of the initial filing and may include “any lawful.” In 
 addition to purpose, also include the NAICS code where indicated. NAICS code may not conflict with the 
 purpose listed. A complete list of NAICS codes is available online under the Corporations Section at 
 www.commerce.alaska.gov/occ. 
  
 ITEM 5: Registered Agent 
 The registered agent of this foreign LLC must be an individual who is a resident of Alaska, or a corporation 
 (excluding LLC, LP and LLP) registered and in good standing with this office.   The registered agent is 
 statutorily responsible for receiving and forwarding processes, notices, or demands on to the last known 
 address of the entity.   A LLC may not act as a registered agent.   A physical address and a mailing address in 
 the State of Alaska must be given.   
  
 08-497 (Rev. 07/15//2013)            Certificate of Registration Instructions  
  

ITEM 6: Principal Office Address 
Address of the company wherever located. 
 
ITEM 7-8: Management 
List the members and/or managers of the LLC. If the LLC is managed by members, there will be no managers 
and at least one member. If the LLC is managed by managers, there must be at least one member and one 
manager; additionally the managers have sole decision making power within the LLC.  
 
Signatures 
The printed name and signature of a person who is authorized by law of the state or other jurisdiction where 
the company was organized to sign the application.  
 
NOTE: Persons who sign documents filed with the commissioner that are known to the person to be false in 
material respects are guilty of a class A misdemeanor.  
 
Mail the Application for Certificate of Registration and the $350.00 filing fee in U.S. dollars to: 
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 
 
STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 
10-15 business days. All applications are reviewed in the date order they are received. To file your application 
online for immediate processing, visit our website at: www.commerce.alaska.gov/occ. 
 
ADDITIONAL RESOURCES: 
    Professional License:  

 For information regarding what professions require a Professional License, statutes, how to obtain a 
 Professional License, and/or the expiration date if you already have a Professional License, go to the 
 Professional License Section of our website at www.commerce.alaska.gov/occ.  

    Business License:  

 For the privilege of engaging in a business in the State of Alaska, a Business License is required for a new 
 entity. For information regarding business licenses, statutes, and how to obtain a Business License, go to 
 the Business License Section of our website at www.commerce.alaska.gov/occ.  

    Alaska Corporate Net Income Tax 
 Every corporation earning gross income from sources within the state, except for those corporations that 
 are specifically exempted, must file a corporation net income tax return. Contact the Alaska Department of 
 Revenue, Tax Division, PO Box 110420, Juneau, Alaska, 99811-0420, telephone number (907) 465-2320 
 for more information.     
 
08-497 (Rev. 07/15//2013)        Certificate of Registration Instructions  
 

               State of Alaska 
                                                                                     DO NOT STAMP ABOVE THIS BOX 
               Division of Corporations, Business and Professional Licensing 
                                                                                     Office Use Only       CORP 
               CORPORATIONS SECTION 
               PO Box 110806 
               Juneau, AK  99811-0806 
               Phone: (907) 465-2550 
               Fax: (907) 465-2974 
               Website: www.commerce.alaska.gov/occ 

                         CERTIFICATE OF REGISTRATION 
                                  Foreign Limited Liability Company 
                                      AS 10.50.615 

  $350.00 Filing Fee 

Pursuant to the provisions set forth in Alaska Statutes 10.50.615, the undersigned company applies for a 
Certificate of Registration and, for that purpose, submits the following statement:  

ITEM 1:  Legal name of the limited liability company must contain the words “limited liability company” or the 
abbreviation “L.L.C.,” or “LLC”.   

  This foreign entity is active and in good standing in the state/country of domicile.  

ITEM 2: The assumed name the company elects to use in Alaska if the legal name is not available: 

ITEM 3: The state of domicile, or “home state”; date of incorporation in the state of domicile (mm/dd/yyyy format); 
and the duration, or “life expectancy” of the company: 
State of domicile:                    Date of Incorporation:                 Duration: ___/___/_____ 
                                      ___/___/_____                                   Perpetual  

ITEM 4: The purpose of the company (may include “any lawful”) and the 6 digit NAICS Industry Grouping Code 
that most clearly describes the initial activities of the company: 
Purpose:                                                            NAICS
                                                                    code: 

ITEM 5:  Registered agent name and address (must include a physical and mailing address in Alaska): 
Name: 
Physical address:                                      City:                         AK  Zip Code:  
Mailing address:                                       City:                         AK  Zip Code:  

ITEM 6 :Principal office address of the company wherever located: 
Name: 

Physical address: 

Mailing address: 
08-497 (Rev. 0715//2013)              Page 1of         2

ITEM 7  : Management. 
       The limited liability company is managed by its members. 
       The limited liability company is managed by a manager.  

ITEM 8 :The limited liability company must have at least one member, and, in addition, list the name, address 
and % held of each person/entity owning at least 5% in the company.  
Name                    Mailing address           City                  State ZIP code              % held 

Attach an additional sheet if necessary.  

If the company is managed by a manager, list the name, address and % held (if applicable) of each manager. 
Name                    Mailing address           City                  State ZIP code              % held 

Attach an additional sheet if necessary.  

Signatures: The printed name and signature of a person who is authorized by law of the state or other 
jurisdiction where the company was organized to sign the application. 

Signature of Authorized Person                    Printed name of Authorized Person                 Date 

NOTE: Persons who sign documents filed with the commissioner that are known to the person to be false in 
material respects are guilty of a class A misdemeanor.  

Mail the Application for Certificate of Registration and the $350.00 filing fee in U.S. dollars to: 
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 

STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
approximately 10-15 business days. All applications are reviewed in the date order they are received. To file 
your application online for immediate processing, visit our website at: www.commerce.alaska.gov/occ.   

08-497 (Rev. 0715//2013)                          Page 2of  2

              State of Alaska 
                                                                               DO NOT STAMP ABOVE THIS BOX 
              Division of Corporations, Business and Professional Licensing 
                                                                               Office Use Only       CORP 
              CORPORATIONS SECTION 
              PO Box 110806 
              Juneau, AK  99811-0806 
              Phone: (907) 465-2550 
              Fax: (907) 465-2974 
              Website: www.commerce.alaska.gov/occ 

                          CONTACT INFORMATION SHEET  

Please return this document with your filing. This information will only be used to resolve questions with the filings 
attached. NOTE: this form will not be filed for record or appear online. 

Name of entity as it appears on filing: 

To resolve questions with this filing, contact: 
 Name: 

 Email:                                                                  Phone:

 Mailing address: 

Return documents to: 
 Name: 

 Company: 

 Mailing address: 

Attach this form to your filings. Send all documents to: 
State of Alaska, Corporations Section, PO Box 110806, Juneau, AK  99811-0806 

STANDARD PROCESSING TIME for complete and correct applications submitted to this office is 
approximately 10-15 business days. All applications are reviewed in the date order they are received.  

 08-561 (Rev. 02/01/2012)                       Page  1of 1

                         THE  TATE S                                                                                                          FOR DIVISION USE ONLY 
                         of 
                                                                                                                                                              
                           ALASKA 
                         Department of Commerce, Community, and Economic Development 
                         Division of Corporations, Business and Professional Licensing 
 
          State of Alaska  
          Department of Commerce, Community, and Economic Development 
          Division of      Corporations, Business and Professional Licensing 
          PO Box 110806, Juneau, AK 99811 
          Phone: (907)     465-2550 
 
Credit Card Payment Form                                                                                        

All major credit cards are accepted. For security purposes, do not email credit card information. 
Include this credit card payment form with your application.  

Name of Applicant or Licensee:      _________________________________________________________________________________________________________________________ 

Program Type:   ________________________________________________________       License Number (if applicable):                                    ________________________________ 

 I wish to make          payment by credit card for the following(check all that apply):                                                                        AMOUNT           

          Application Fee:  _________________________________________________________________________________________________                           __________________________         

          License or Renewal Fee:        _________________________________________________________________________________                              __________________________         

          Other (name change, wall certificate, fine, duplicate license, exam, etc.):         

            1.           _____________________________________________________________________________________________________________________               __________________________ 

            2.          _____________________________________________________________________________________________________________________                __________________________         

                                                                                                       TOTAL:            ___________________________ 

Name (as shown on credit card):   ________________________________________________________________________________________________________________________ 

Mailing Address:            ___________________________________________________________________________________________________________________________________________________ 

Phone Number:   ________________________________________________________      Email (optional):               _______________________________________________________ 

Signature of Credit Card Holder:                     _____________________________________________________________________________________________________________________ 

  08-4438                   Rev 12/26/18                   Credit Card Payment Form (all major cards accepted) 
  
   CREDIT CARD INFO:  Your payment cannot be processed unless all fields are completed! 
   
       1. Account Number:                                                                                       All four fields MUST 

                                                                                                                                                 be completed! 
       2. Expiration Date:                                                                                                                                    

                                                                                                                This section will be 
       3. Billing ZIP Code: 
                                                                                                                destroyed after the 
       4. Security Code:                                                                                       payment is processed.