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This form is designed to be filled out online for your convenience.
Complete the necessary information, print, sign and mail.
State of Missouri John R. Ashcroft, Secretary of State
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Corporations Division
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 ofon 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 mustbe completed and include a
street address):
Name Address (PO Box may onlybe 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 onlybe 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.
(Please see next page )
Name and address to return filed document:
Name:
Address:
City, State, and Zip Code:
LLC-4 (01/2017)
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