"Foreign Registration Statement Form - Limited Liability Company - Foreign" - Connecticut

Foreign Registration Statement Form - Limited Liability Company - Foreign is a legal document that was released by the Connecticut Secretary of the State - a government authority operating within Connecticut.

Form Details:

  • Released on July 1, 2017;
  • The latest edition currently provided by the Connecticut Secretary of the State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Connecticut Secretary of the State.

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SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
www.concord-sots.ct.gov
PHONE:
WEBSITE:
FOREIGN REGISTRATION STATEMENT
LIMITED LIABILITY COMPANY - FOREIGN
C.G.S. §34-275b
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING FEE: $120
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
NAME:
MAKE CHECKS PAYABLE TO "SECRETARY
OF THE STATE"
MAILING ADDRESS:
CITY:
STATE:
ZIP:
1. NAME OF LIMITED LIABILITY COMPANY IN STATE OR COUNTRY OF FORMATION - REQUIRED:
(MUST INCLUDE BUSINESS DESIGNATION SUCH AS LLC, L.L.C., ETC.)
2. IF NAME AT "1" IS NOT AVAILABLE, ALTERNATE NAME TO BE USED IN CONNECTICUT:
(MUST INCLUDE BUSINESS DESIGNATION SUCH AS LLC, L.L.C., ETC.)
3. STATE/COUNTRY OF FORMATION - REQUIRED:
4. DATE OF FORMATION: REQUIRED:
(MM/DD/YYYY)
5. DATE LIMITED LIABILITY COMPANY BEGAN / WILL BEGIN TRANSACTING BUSINESS IN
CONNECTICUT - REQUIRED:
DATE (MM/DD/YYYY)
6. PRINCIPAL OFFICE ADDRESS AND MAILING ADDRESSES: REQUIRED:
PRINCIPAL OFFICE ADDRESS:
PRINCIPAL OFFICE MAILING ADDRESS:
(P.O. BOX IS ACCEPTABLE)
STREET:
STREET OR P.O.BOX:
CITY:
CITY:
STATE:
STATE:
ZIP:
ZIP:
7. IF REQUIRED IN STATE/COUNTRY OF FORMATION:
OFFICE ADDRESS IN STATE OF FORMATION:
MAILING ADDRESS IN STATE OF FORMATION:
(P.O. BOX IS ACCEPTABLE)
STREET:
STREET OR P.O.BOX:
CITY:
CITY:
STATE:
STATE:
ZIP:
ZIP:
PAGE 1 OF 3
Rev. 7/2017
SECRETARY OF THE STATE OF CONNECTICUT
MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470
DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106
860-509-6003
www.concord-sots.ct.gov
PHONE:
WEBSITE:
FOREIGN REGISTRATION STATEMENT
LIMITED LIABILITY COMPANY - FOREIGN
C.G.S. §34-275b
USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY.
FILING FEE: $120
FILING PARTY
:
(CONFIRMATION WILL BE SENT TO THIS ADDRESS)
NAME:
MAKE CHECKS PAYABLE TO "SECRETARY
OF THE STATE"
MAILING ADDRESS:
CITY:
STATE:
ZIP:
1. NAME OF LIMITED LIABILITY COMPANY IN STATE OR COUNTRY OF FORMATION - REQUIRED:
(MUST INCLUDE BUSINESS DESIGNATION SUCH AS LLC, L.L.C., ETC.)
2. IF NAME AT "1" IS NOT AVAILABLE, ALTERNATE NAME TO BE USED IN CONNECTICUT:
(MUST INCLUDE BUSINESS DESIGNATION SUCH AS LLC, L.L.C., ETC.)
3. STATE/COUNTRY OF FORMATION - REQUIRED:
4. DATE OF FORMATION: REQUIRED:
(MM/DD/YYYY)
5. DATE LIMITED LIABILITY COMPANY BEGAN / WILL BEGIN TRANSACTING BUSINESS IN
CONNECTICUT - REQUIRED:
DATE (MM/DD/YYYY)
6. PRINCIPAL OFFICE ADDRESS AND MAILING ADDRESSES: REQUIRED:
PRINCIPAL OFFICE ADDRESS:
PRINCIPAL OFFICE MAILING ADDRESS:
(P.O. BOX IS ACCEPTABLE)
STREET:
STREET OR P.O.BOX:
CITY:
CITY:
STATE:
STATE:
ZIP:
ZIP:
7. IF REQUIRED IN STATE/COUNTRY OF FORMATION:
OFFICE ADDRESS IN STATE OF FORMATION:
MAILING ADDRESS IN STATE OF FORMATION:
(P.O. BOX IS ACCEPTABLE)
STREET:
STREET OR P.O.BOX:
CITY:
CITY:
STATE:
STATE:
ZIP:
ZIP:
PAGE 1 OF 3
Rev. 7/2017
8. APPOINTMENT OF REGISTERED AGENT FOR SERVICE OF PROCESS - REQUIRED: THE LLC MAY NOT BE
APPOINTED AS ITS OWN AGENT: HOWEVER A MANAGER/MEMBER OF THE LLC RESIDING IN
CONNECTICUT MAY BE THE AGENT.
(CHECK A OR COMPLETE B)
A.
THE LIMITED LIABILITY COMPANY APPOINTS THE SECRETARY OF THE STATE OF CONNECTICUT AND
HIS/HER SUCCESSORS IN OFFICE TO BE ITS AGENT, UPON WHOM ANY PROCESS, IN ANY ACTION OR
PROCESSING AGAINST IT, MAY BE SERVED.
B. NAME OF AGENT (SEE INSTRUCTIONS)
SIGNATURE ACCEPTING APPOINTMENT:
X
(IF AGENT IS A BUSINESS ALSO PRINT NAME AND TITLE OF PERSON SIGNING.)
BUSINESS ADDRESS
CONNECTICUT RESIDENCE ADDRESS
(P.O.BOX UNACCEPTABLE)
(P.O.BOX UNACCEPTABLE)
STREET:
STREET:
CITY:
CITY:
STATE:
ZIP:
STATE:
ZIP:
CONNECTICUT MAILING ADDRESS: (REQUIRED):
(P.O.BOX ACCEPTABLE)
STREET OR P.O.BOX:
CITY:
ZIP:
STATE:
9. MANAGER OR MEMBER INFORMATION-REQUIRED:
(MUST LIST AT LEAST ONE MANAGER OR MEMBER OF THE LLC.)
BUSINESS ADDRESS
RESIDENCE ADDRESS:
NAME
TITLE
(No. P.O.Box)
(No. P.O.Box)
IF NONE, MUST STATE "NONE"
10. ENTITY EMAIL ADDRESS - REQUIRED:
(IF NONE, MUST STATE "NONE.") DO NOT LEAVE BLANK
11. EXECUTION - REQUIRED: (SUBJECT TO PENALTY OF FALSE STATEMENT)
THE UNDERSIGNED ASSERTS THAT THE SUBJECT LIMITED LIABILITY COMPANY IS A FOREIGN LIMITED LIABILITY COMPANY
DATE (MM/DD/YYYY)
NAME OF SIGNATORY
CAPACITY/TITLE OF SIGNATORY
SIGNATURE
AN ANNUAL REPORT WILL BE DUE YEARLY TO BE FILED BETWEEN JANUARY 1
ST
& APRIL 1
ST
AND CAN BE EASILY FILED ONLINE
www.concord-sots.ct.gov
@
CONTACT YOUR TAX ADVISOR OR THE TAXPAYER SERVICE CENTER AT THE DEPARTMENT OF REVENUE SERVICES AS TO ANY
POTENTIAL TAX LIABILITY RELATING TO YOUR BUSINESS, INCLUDING QUESTIONS ABOUT THE BUSINESS ENTITY TAX.
www.ct.gov/drs
TAX PAYER SERVICE CENTER: (800) 382-9463 OR (860) 297-5962 OR GO TO
PAGE 2 OF 3
Rev. 7/2017
INSTRUCTIONS
1. Provide the name of the limited liability company. (Name must include a business designation such as L.L.C., LLC,
etc.)
2. If name provided in number 1 is not available for use in Connecticut, provide an alternate name that shall be used in
the state of Connecticut. The name must be distinguishable from all other business names on record at the Office of the
Secretary of State and must contain an appropriate limited liability company designation such as LLC.
3. Provide the limited company's state of formation.
4. Provide the date upon which the limited liability company was formed in its state or country of formation. The date
must include a month, day and year.
5. Provide the exact month, day and year upon which the limited liability company began/will begin transacting
business in Connecticut, If the limited liability company has not yet connected transacting business in Connecticut,
please make a statement to that effect.
6. Provide the street number, street name, city , state and postal code for the principal office address. The principal
office mailing address may include a P O Box.
7. If the limited liability company is required to maintain an office in its state of formation, provide the street address
(must include a street number, street name, city, state, postal code and country (if other than the United States) and
mailing address of the office (may include a P O Box).
8. The limited liability company may appoint either.
A. The Secretary of the State
or
B. Any individual who is a resident of Connecticut, including a manager or member of the LLC. (An individual must
provide the complete street address of his or her business and a complete Connecticut residence address AND a
mailing address.) or
Any of the following business types, on record with this office:
• A Connecticut corporation, limited liability company, limited liability partnership or statutory trust • A foreign corporation,
limited liability company, limited liability partnership or statutory trust, which has obtained a certificate of authority to
transact business in Connecticut and has a Connecticut address on file with this office.
The business must provide a Connecticut business address in Box 8B AND a Connecticut mailing address.
Print the name & title under the signature of the individual signing acceptance on behalf of the business agent.
9. The Limited Liability Company must list the name, title, residence and business address of one manager or member
of the Limited Liability Company. (Attach an extra sheet if listing more than one manager or member).
10. Provide the entity's Email address. (If none, must state "NONE".) The Secretary will notify entities via email when
their Annual Reports are due. DO NOT LEAVE BLANK
11. The document must be executed/signed by an authorized official of the limited liability company. That person must
print or type his/her full legal name, state the capacity/title under which he/she signs and provide his/her signature. The
execution/signature constitutes a legal statement under the penalties of false statement that the information provided in
the document is true.
For Connecticut business entity tax purposes, a foreign limited liability company will be subject to the tax:
• For the taxable year during which its application for registration is filed with the Connecticut Secretary of the State,
• For the taxable year during which its certificate of cancellation is filed with the Connecticut Secretary of the State, and
• For all intervening taxable years. For more information on the Business Entity Tax go to www.ct.gov/BET or call DRS
during business hours, Monday through Friday, at 1-800-382-9463 (Connecticut calls outside the Greater Hartford calling
area only); or 860-297-5962 (from anywhere).
An annual report will be due yearly to be filed between January 1st and April 1st and can be easily filed online @
www.concord.sots.ct.gov
PAGE 3 OF 3
Rev. 7/2017
OFFICE OF THE SECRETARY OF THE STATE
MAILING ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
P.O. BOX 150470
HARTFORD, CT 06115-0470
DELIVERY ADDRESS:
COMMERCIAL RECORDING DIVISION
CONNECTICUT SECRETARY OF THE STATE
30 TRINITY STREET
HARTFORD, CT 06106
PHONE: 860-509-6003
WEBSITE:
www.concord-sots.ct.gov
Rev. 7/2017
DO NOT SCAN THIS PAGE
INSTRUCTIONS
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