This form is designed to be filled out online for your convenience. 
                       State of Missouri                                                Complete the necessary information, print, sign and mail.
                       John R. Ashcroft, Secretary of State 
                       Corporations Division                                                                                                           Print      Reset
                       PO Box 778 / 600 W. Main St., Rm. 322
                       Jefferson City, MO 65102 

                                                Application for  Registration of a Foreign
                                                           Limited Liability Company
                                                                    (Submit with filing fee of $105.00)

1. The name of the foreign limited liability company is:

2. The name under which the foreign limited liability company will conduct business in Missouri is (must contain “limited company,
      “limited liability company”, “LC”, “LLC”, “L.C.”, or “L.L.C.”) (must be filled out if different from line (1)):

3. The foreign limited liability company was formed under the laws of                                                                                             on the 
                                                                                                                    (state or jurisdiction)
      date of                                             .
                       (month/day/year) 

4. The purpose of the foreign limited liability company or the general character of the business it proposes to transact in this state is:

5. The name and address of the limited liability company’s registered agent in Missouri is (this line must                     be completed and include a
      street address):

      Name                              Address (PO Box may only be used in conjunction with a      physical street address)                     City/State/Zip 

The Secretary of State is appointed agent for service of process if the foreign limited liability company fails to maintain a registered agent.  Note: failure to maintain
a registered agent constitutes grounds to cancel the registration of the foreign limited liability company.

6. The address of the registered office in the jurisdiction organized. If none required, then the principal office address of the foreign
      limited liability company is:

                                        Address (PO Box may only be used in conjunction with      a physical street address)                     City/State/Zip 

7. This application must include a current certificate of good standing/existence from the secretary of state or other similar official in
   the state of domicile. Such document should be dated within 60 calendar days from filing.

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Name and address to return filed document:

Name:

Address:

City, State, and Zip Code:
                                                                                                                                                       LLC-4 (01/2017)

8. • Series LLC (OPTIONAL) Pursuant to Section 347.186, the foreign limited liability company may establish a designated series
   in its operating agreement.  The names of the series must include the full name of the limited liability company under which it has
   been admitted to transact business in this state and are the following:

   New Series: 
   • The limited liability company gives notice that the series has limited liability.

   New Series: 
   • The limited liability company gives notice     that the series has limited liability.

   New Series: 
   • The limited liability company gives notice     that the series has limited liability.

(Each separate series must also file an Attachment Form LLC 4A.)
In Affirmation thereof, the facts stated above are true and correct.
(The undersigned    understands that false statements made   in this filing are subject   to the penalties provided under Section 575.040,  RSMo)

Authorized Signature                                             Printed Name                                              Date 

Authorized Signature                                             Printed Name                                              Date 

Authorized Signature                                             Printed Name                                              Date 

                                                                                                                           LLC-4 (01/2017)