Application For Reinstatement Domestic Or Foreign Entities {4160}

INSTRUCTIONS: 1. Use 8275224 x 11224 white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office on the web at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. 6. The Application for Reinstatement must include the following: Certificate of Clearance issued by the Indiana Department of Revenue Business Entities Reports for all outstanding years due 7. A Series cannot apply for reinstatement for the Master LLC. The Application for Reinstatement must be submitted by the Master LLC. 8. Before submitting this form, please visit www.INBiz.in.gov to check if the business name is still available. If the business name is not available, please submit Articles of Amendment with this filing to change the name. NOTE: This application for reinstatement cannot be accepted without a Certificate of Clearance for reinstatement from the Indiana Department of Revenue. NOTE: This application must be submitted within five (5) years of the effective date of the administrative dissolution. (SOS use only) (If different from above 226 SOS use only) American LegalNet, Inc. www.FormsWorkFlow.com For foreign entities only: (number and street, city, state, and ZIP code) (month, day, year) (month, day, year) Please check the reason why the entity was administratively dissolved or revoked. You must include Business Entity Reports and payment for all years. (Do not complete if dissolved / revoked for failure to file Business Entity Reports.) To determine if your Registered Agent is a Commercial Registered Agent (CRA), go to INBIZ.in.gov. Provide either commercial registered agent or noncommercial registered agent information below. (Do not provide address.) (number and street) (A P.O. Box is not acceptable unless accompanied by a Rural Route number.) (OPTIONAL) American LegalNet, Inc. www.FormsWorkFlow.com