Form LLC-12A "Attachment to Statement of Information" - California

What Is Form LLC-12A?

This is a legal form that was released by the California Secretary of State - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2018;
  • The latest edition provided by the California Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form LLC-12A by clicking the link below or browse more documents and templates provided by the California Secretary of State.

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Download Form LLC-12A "Attachment to Statement of Information" - California

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Attachment to
LLC-12A
Statement of Information
Attachment
(Limited Liability Company)
A. Lim ited Liability Company Nam e (Enter the exact name on file w ith the California
Secretary of State.)
Ab ove Space For Office Use Only
B.
12-Digit Secretary of State Entity (File) Num ber
C. State, Foreign Country, or Place of Organization (only if formed outside of
California)
D. List of Additional Manager(s) or Mem ber(s) - If the manager/member is an individual, enter the individual’s name and address. If the
manager/member is an entity, enter the entity’s name and address. Note: The LLC cannot serve as its ow n manager or member.
2a. First Name – Do not complete Item 2b
Middle Name
Last Name
Suf fix
2b. Entity Name – Do not complete Item 2a
2c. Address
City (no abbreviations)
State
Zip Code
3a. First Name – Do not complete Item 3b
Middle Name
Last Name
Suf fix
3b. Entity Name – Do not complete Item 3a
3c. Address
City (no abbreviations)
State
Zip Code
4a. First Name – Do not complete Item 4b
Middle Name
Last Name
Suf fix
4b. Entity Name – Do not complete Item 4a
4c. Address
City (no abbreviations)
State
Zip Code
5a. First Name – Do not complete Item 5b
Middle Name
Last Name
Suf fix
5b. Entity Name – Do not complete Item 5a
5c. Address
City (no abbreviations)
State
Zip Code
6a. First Name – Do not complete Item 6b
Middle Name
Last Name
Suf fix
6b. Entity Name – Do not complete Item 6a
6c. Address
City (no abbreviations)
State
Zip Code
7a. First Name – Do not complete Item 7b
Middle Name
Last Name
Suf fix
7b. Entity Name – Do not complete Item 7a
7c. Address
City (no abbreviations)
State
Zip Code
8a. First Name – Do not complete Item 8b
Middle Name
Last Name
Suf fix
8b. Entity Name – Do not complete Item 8a
8c. Address
City (no abbreviations)
State
Zip Code
2018 California Secretary of State
Attachment
LLC-12A -
(REV 01/2018)
bizfile.sos.ca.gov
Clear Form
Print Form
Attachment to
LLC-12A
Statement of Information
Attachment
(Limited Liability Company)
A. Lim ited Liability Company Nam e (Enter the exact name on file w ith the California
Secretary of State.)
Ab ove Space For Office Use Only
B.
12-Digit Secretary of State Entity (File) Num ber
C. State, Foreign Country, or Place of Organization (only if formed outside of
California)
D. List of Additional Manager(s) or Mem ber(s) - If the manager/member is an individual, enter the individual’s name and address. If the
manager/member is an entity, enter the entity’s name and address. Note: The LLC cannot serve as its ow n manager or member.
2a. First Name – Do not complete Item 2b
Middle Name
Last Name
Suf fix
2b. Entity Name – Do not complete Item 2a
2c. Address
City (no abbreviations)
State
Zip Code
3a. First Name – Do not complete Item 3b
Middle Name
Last Name
Suf fix
3b. Entity Name – Do not complete Item 3a
3c. Address
City (no abbreviations)
State
Zip Code
4a. First Name – Do not complete Item 4b
Middle Name
Last Name
Suf fix
4b. Entity Name – Do not complete Item 4a
4c. Address
City (no abbreviations)
State
Zip Code
5a. First Name – Do not complete Item 5b
Middle Name
Last Name
Suf fix
5b. Entity Name – Do not complete Item 5a
5c. Address
City (no abbreviations)
State
Zip Code
6a. First Name – Do not complete Item 6b
Middle Name
Last Name
Suf fix
6b. Entity Name – Do not complete Item 6a
6c. Address
City (no abbreviations)
State
Zip Code
7a. First Name – Do not complete Item 7b
Middle Name
Last Name
Suf fix
7b. Entity Name – Do not complete Item 7a
7c. Address
City (no abbreviations)
State
Zip Code
8a. First Name – Do not complete Item 8b
Middle Name
Last Name
Suf fix
8b. Entity Name – Do not complete Item 8a
8c. Address
City (no abbreviations)
State
Zip Code
2018 California Secretary of State
Attachment
LLC-12A -
(REV 01/2018)
bizfile.sos.ca.gov
Clear Form
Print Form