Add Members to LLC – The S. Miller Law Firm

Member/Manager Information *

First

Last

Full Name

Manager? *

Phone Number *

Email *

Personal Address *

Date of Birth *

Name of LLC:

Please list the name of the LLC in your order of preference. The Secretary of State requires that you list two additional names in case your first choice is already taken or otherwise rejected by the Secretary of State’s Office (be specific, i.e. “and” or “&”, whether or not the name begins with “The…”,etc).

If the above Members/Managers are married, list full name(s) of spouse(s) if not listed above:

Business/Mailing Address *

City, State, Zip *

State of Organization for LLC or Corporation (if applicable)

Capital Contributions and Ownership Interest *

Please indicate the dollar amount or form of this member’s capital contribution and their percentage ownership interest in the Company.

Please type your name below to virtually sign (e-signature okay): *

If you have any questions regarding information requested on this form please call Shakila Miller-Brewer at (346) 718-8971 or email [email protected].