Free RETURN TO - South Dakota

Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845

ANNUAL REPORT
FOREIGN L.L.C.
Please Type or Print Clearly in Ink

FILE DATE

_________________

RECEIPT NO ________________

FILING FEE: $50 Make check payable to SECRETARY OF STATE
1. L.L.C. ID and Name:

Clear Form
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Telephone # _____________________ FAX # ________________________

Search for Corporate ID, Name and Agent

FILING DATE: Due during the month the Certificate of Authority was issued, and delinquent after the last day of the following month.

2. The jurisdiction under whose law it is formed ___________________________________________________________ 3. The address of the principal executive office in or out of the State of South Dakota. ______________________________________________________________________________________________
Street Address City State ZIP+4

______________________________________________________________________________________________
Mailing Address (Optional) City State ZIP+4

4. The name of the South Dakota Registered Agent _______________________________________________________ ______________________________________________________________________________________________
Street Address (Required to be a South Dakota Address) City State ZIP+4

______________________________________________________________________________________________
Mailing Address (Optional ­ Required to be a South Dakota Address) City State ZIP+4

5. The names and business addresses of its managers. If the L.L.C. is member-managed the names and addresses of the members need not be set forth. ______________________________________________________________________________________________
Manager Street Address City State ZIP+4

______________________________________________________________________________________________
Manager Street Address City State ZIP+4

______________________________________________________________________________________________
Manager Street Address City State ZIP+4

Dated ____________________________

______________________________________________
(Signature of an authorized manager or member)

______________________________________________
(Printed Name)

______________________________________________
(Title)

Annualreportforeignllc 2008