LIMITED LIABILITY CORPORATION (LLC) Meeting Date: ____________________________________ Signing Date: _____________________________________ File No.: ______________________ INFORMATION Name of LLC Street Physical Business Address City/State/Zip Street Mailing Address (if different) City/State/Zip County of LLC Description of Operations Telephone Fax Email Professional license No. (if any) OWNERS Name(s) Social Security Number % of Ownership
LIMITED LIABILITY CORPORATION (LLC) Meeting Date: ____________________________________ Signing Date: _____________________________________ File No.: ______________________ Name of LLC Physical Business Address Street City/State/Zip Mailing Address (if different) Street City/State/Zip County of LLC Description of Operations Telephone Fax Email Professional license No. (if any) OWNERS Name(s) Social Security Number % of Ownership INFORMATION