Fillable New York Dos 1710 Form in PDF

New York State

Department of State

Division of Corporations, State Records and Uniform Commercial Code

One Commerce Plaza, 99 Washington Avenue

Albany, NY 12231

www.dos.ny.gov

CERTIFICATE OF PUBLICATION

OF

(Name of Foreign Professional Service Limited Liability Company)

Under Section 1306 of the Limited Liability Company Law

The undersigned is the

(Title*)

of

(Name of Foreign Professional Service Limited Liability Company)

If the name of the foreign professional service limited liability company has changed, the name under which it was authorized is:

If applicable, the fictitious name of the foreign professional service limited liability company has agreed to use in this state is:

The application for authority was filed by the Department of State on:

The published notices described in the annexed affidavits of publication contain all of the information required by Section 1306 of the Limited Liability Company Law.

The newspapers described in such affidavits of publication satisfy the requirements set forth in the Limited Liability Company Law and the designation made by the county clerk.

I certify the foregoing statements to be true under penalties of perjury.

(Date)

X

(Signature)

(Type or Print Name)

*This certificate must be signed by a member, manager, authorized person or attorney-in-fact. If the certificate is signed by an attorney-in-fact, include the name and title of the person for whom the attorney-in-fact is acting. (Example, John Smith, attorney-in-fact for Robert Johnson, member.)

CERTIFICATE OF PUBLICATION

OF

(Name of Foreign Professional Service Limited Liability Company)

Under Section 1306 of the Limited Liability Company Law

Filed by:

(Name)

(Mailing Address)

(City, State and ZIP Code)

Note: This form was prepared by the New York State Department of State for filing a certificate of publication for a foreign professional service limited liability company. You are not required to use this form. You may draft your own form or use forms available from legal stationery stores. The Department of State recommends that legal documents be prepared under the guidance of an attorney. This certificate of publication, with the affidavits of publication of the newspapers annexed thereto, must be submitted with a $50 filing fee payable to the Department of State.

(For office use only)

Attach this page after the affidavits of publication.