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Application for Certificate of Authority (Tennessee)

This is an application for certificate of authority of a limited liability company in Tennessee. The form provided here is simply a sample of what the actual Form SS 4233 looks like.

For Office Use Only


APPLICATION FOR
CERTIFICATE OF AUTHORITY

Corporate Filings
312 Eighth Avenue North
6th Floor, William R. Snodgrass Tower
Nashville, TN 37243

To the Secretary of State of the State of Tennessee:

Pursuant to the provisions of § 48-246-301 of the Tennessee Limited Liability Company Act, the undersigned hereby applies for a certificate of authority to transact business in the State of Tennessee, and for that purpose sets forth:

1. The name of the Limited Liability Company is:

________________________

If different, the name under which the certificate of authority is to be obtained is:

________________________

NOTE: The Secretary of State of the State of Tennessee may not issue a certificate of authority to a foreign Limited Liability Company if its name does not comply with the requirements of § 48-207-101 of the Tennessee Limited Liability Company Act. If obtaining a certificate of authority under an assumed Limited Liability Company name, an application must be filed pursuant to § 48-207-101(d).

2. The state or country under whose law it is formed is:

________________________

Street ________________________

City/State ________________________

Zip Code ________________________

3. The date of its organization is: ________________________ (must be month, day and year)

4. The complete street address (including zip code) of its principal office is:

Street ________________________

City/State ________________________

County ________________________

Zip Code ________________________

5. The complete street address (including the county and the zip code) of its registered office in Tennessee:

Street ________________________

City/State ________________________

County ________________________

Zip Code ________________________

The name of its registered agent at that office is: _____________

6. The number of members at the date of filing _______________

7. If the limited liability company commenced doing business in Tennessee prior to the approval of this application, the date of commencement

_____________________ (month, day and year)

NOTE: This application must be accompanied by a certificate of existence (or a document of similar import) duly authenticated by the Secretary of State or other official having custody of the Limited Liability Company records in the state or country under whose law it is organized. The certificate shall not bear a date of more than two (2) months prior to the date the application is filed in this state.

Signature Date ________________________

Name of Limited Liability Company ________________________

Signer's Capacity ________________________

Signature ________________________

Name ________________________ (typed or printed)

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