ANNUAL CORPORATION REPORT



ANNUAL LIMITED LIABLITY COMPANY (“LLC”) REPORT

FILING FEE $50

FILE ORIGINAL AND TWO COPY

FILING: THE INITIAL REPORT MUST BE FILED WITHIN 60 DAYS OF INCORPORATION

ANNUAL REPORTS MUST BE FILED ON OR BEFORE MARCH 1ST OF EACH YEAR

FILE WITH: REGISTRAR OF CORPORATIONS

Department of Commerce

Capitol Hill, 1st Floor-DoorNo: (8)

Caller Box 10007

Saipan, MP 96950

INITIAL REPORT REPORT FOR THE YEAR

Domestic LLC Foreign LLC

Name, Address of Designated Office & Telephone No. of LLC State or Country of Organization of LLC:

(Attach map showing location if address is only a P.O. Box)

Address of Principal Office (If Different from Designated Office):

Name, Mailing Address & Telephone No. of Agent for Service of Process:

(Attach map showing location if address is only a P.O. Box)

managers (if manager managed):

Name Nationality Address

members (IF MEMBER managed):

Date Signature

PRINT NAME & TITLE OF PERSON SIGNING

(Must be Member of Member-Managed LLC or Manager of Manager-Managed LLC)

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