Secretary of the State of Connecticut OFFICE USE ONLY PHONE: 860-509-6003 • EMAIL:
[email protected] • WEB: www.concord-sots.ct.gov CERTIFICATE OF ORGANIZATION • Use ink. • Print or type. LIMITED LIABILITY COMPANY – DOMESTIC • Attach additional 8 ½ x 11 sheets if necessary. FILING PARTY (Confirmation will be sent to this address): NAME: FILING FEE: $120 MAILING ADDRESS: Make checks payable to “Secretary of the State” CITY: STATE: ZIP: – 1. NAME OF LIMITED LIABILITY COMPANY (required) (Must include business designation such as LLC, L.L.C., etc.): 2. PRINCIPAL OFFICE ADDRESS (required) (Provide full address): (P.O. Box unacceptable) STREET: CITY: STATE: ZIP: – 3. MAILING ADDRESS (required) (Provide full address): (P.O. Box IS acceptable) STREET OR P.O. BOX: CITY: STATE: ZIP: – NOTE: COMPLETE EITHER 4A BELOW OR 4B ON THE FOLLOWING PAGE, NOT BOTH. 4. APPOINTMENT OF REGISTERED AGENT (required): A. If Agent is an individual, print or type full legal name: _______________________________________________________________ Signature accepting appointment ▸ ____________________________________________________________________________________ BUSINESS ADDRESS (required): CONNECTICUT RESIDENCE ADDRESS (required): (P.O. Box unacceptable) Check box if none: (P.O. Box unacceptable) STREET: STREET: CITY: CITY: STATE: ZIP: – STATE: CT ZIP: – CONNECTICUT MAILING ADDRESS (required): (P.O. Box IS acceptable) STREET OR P.O. BOX: CITY: STATE: CT ZIP: – PAGE 1 OF 2 Rev. 04/2020 Secretary of the State of Connecticut OFFICE USE ONLY PHONE: 860-509-6003 • EMAIL:
[email protected]