Payment for Florida Annual Report Filing - Limited Liability Company.
If you don't have any changes you don't have to fill out all information. Just write no changes required.
 

Company Name (required):	.
Principal Place of Business:	.
City, State, Zip:	.
Mailing Address:	.
City, State, Zip:	.
TOTAL:	..

.
New Resident Agent Information (fill out only if there is change)

Name:	.
Street Address (No P.O. Boxes)	.
City, State, Zip:	.
Signature of new resident agent:	.

.
1. Managing Member/Manager Name And Address

Title:	___ MGR or __MGRM
Name or Entity Name:	.
Street Address	.
City, State, Zip:	.

.
2. Managing Member/Manager Name And Address

Title:	___ MGR or __MGRM
Name or Entity Name:	.
Street Address	.
City, State, Zip:	.

.
3. Managing Member/Manager Name And Address

Title:	___ MGR or __MGRM
Name or Entity Name:	.
Street Address	.
City, State, Zip:	.

An individual named above or an individual signing on behalf of an entity named above must type their name in the 'Managing Member/Manager Signature' block below. A business entity name is not allowed in this block.
 
 

Member/Manager Signature: _________________________  Type your name here:_______________________

The annual report will be filed electronically and you authorize EastBiz.com, Inc. to do electronic filing on your behalf.
 

Requested Services:
State fee for Annual Report Filing: ___ $138.75
State fee for Certificate of Status ____ $ 5.00
Our fee: $10
___________________________
TOTAL: $153.75