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THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR DIVISION OF CORPORATIONS AND TRADEMARKS APPLICATION FOR REGISTRATION OF A TRADE NAME UNDER A LIMITED LIABILITY COMPANY – TNLLC12 • A trade name is not considered registered unless and until you are in receipt of the certified Certificate of Trade Name is issued by this office. You are cautioned against relying on an unofficial representation. The Office of the Lieutenant Governor nor the Division of Corporations and Trademarks shall not be held responsible for any costs incurred as a result of a client moving forward without proper registration. • The Director reserves the right to reject any application for registration. • This form is for use by limited liability companies only. • This form cannot be used for sole proprietorships, partnerships, corporations, limited partnerships, limited liability partnerships, limited liability limited partnerships. • This form must be completed in its entirety. Failure to do so will result in the rejection of the application document. • One (1) original application, with original signature(s) and original notary authentication must be submitted. • The application must be submitted free of obliterated text (no strike through marks, no corrective fluid/tape). Evidence of obliteration will result in the rejection of the application document. • A trade name registered in accordance with the provisions of V.I.C., Title 11, Chapter 21, shall not be the same as nor so similar as to cause confusion with the trade name of any person, partnership, association or corporation, foreign or domestic, doing business under such trade name in the United States Virgin Islands. This office will make that determination. • A fee of $50 must accompany the application. If the application is mailed, be certain to include a check or money order payable to the GOVERNMENT OF THE VIRGIN ISLANDS. The envelope must be addressed to THE OFFICE OF THE LIEUTENANT GOVERNOR – DIVISION OF CORPORATIONS AND TRADEMARKS; 5049 KONGENS GADE; ST. THOMAS, VIRGIN ISLANDS 00802. • A fee of $250.00, in addition to the $25.00 registration fee, guarantees 24-hour processing of this application document. • All trade name registrations must be renewed bi-annually (every two (2) years), on the anniversary of original registration, at a fee of $50.00. Failure to do so will result in the cancellation of the registration. 5049 Kongens Gade Charlotte Amalie, Virgin Islands 00802 Phone - 340.776.8515 Fax - 340.776.4612 1105 King Street Christiansted, Virgin Islands 00820 Phone - 340.773.6449 Fax - 340.773.0330 FORM - TNLLC12 THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR DIVISION OF CORPORATIONS AND TRADEMARKS APPLICATION FOR REGISTRATION OF TRADE NAME UNDER A LIMITED LIABILITY COMPANY VIRGIN ISLANDS CODE – TITLE 11 – CHAPTER 21 LAST NAME OF THE MANAGER or MEMBER FIRST NAME OF THE MANAGER or MEMBER MAILING ADDRESS EMAIL ADDRESS BEST DAYTIME CONTACT NUMBER(S)/CELL PHONE TERRITORY or STATE OF ________________________________________________________ ) JUDICIAL DISTRICT or COUNTY OF ________________________________________________________ ) THIS IS TO CERTIFY THAT ________________________________________________________________________________________________________________________ a limited liability company, organized under the laws of _________________________________________________________________________, the principal office of which is located at __________________________________________________________________, is doing or intends to do business in the United States Virgin Islands and that this business is known or is to be known by the designation, name or style of ________________________________________________________________, that said business is located at ________________________________________________________________________, and that the kind of business to be conducted under said name is ____________________________________________________________________________________________________________________________. IN WITNESS WHEREOF, THE SAID LIMITED LIABILITY COMPANY ___________________________________________________________________________ has to these presents and caused the name to be subscribed and acknowledged by its ______________________________________________________________________ at the city of _______________________________ in the state (district) of _____________________________________ on the ______________ day of _________________________________, __________. ___________________________________________________ Limited Liability Company MANAGER MEMBER ________________________________________________ ___________________________________________ Printed Name Printed Name ________________________________________________ ___________________________________________ Signature Signature ACKNOWLEDGEMENT TERRITORY OF THE VIRGIN ISLANDS ) JUDICIAL DISTRICT OF _____________ ) On this, the _______ day of __________________, _______, before me, the undersigned ________________________________________________________________ personally appeared who acknowledged himself/herself to be the Member or Manager of ________________________________________________________, a Limited Liability Company, and that he/she, as such being authorized so to do, executed the foregoing instrument for the purpose therein contained by signing the name of the Limited Liability Company. IN WITNESS WHEREOF, I hereto set my hand and official seal. ____________________________________________ Notary Public __________________________________ My Commission Expires FOR OFFICIAL USE ONLY DATE RECEIVED RECEIVED BY PAYMENT AMOUNT RECEIVED PAYMENT TYPE RECEIPT NO. I DECLARE, UNDER PENALTY OF PERJURY, UNDER THE LAWS OF THE UNITED STATES VIRGIN ISLANDS, THAT ALL STATEMENTS CONTAINED IN THIS APPLICATION, AND ANY ACCOMPANYING DOCUMENTS, ARE TRUE AND CORRECT, WITH FULL KNOWLEDGE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE SUBJECT TO INVESTIGATION AND THAT ANY FALSE OR DISHONEST ANSWER TO ANY QUESTION MAY BE GROUNDS FOR DENIAL OR SUBSEQUENT REVOCATION OF REGISTRATION. SIGN