L-115 Rev. 11/2014
STATEMENT OF AUTHORITY
Limited Liability Company
Pursuant to the provisions of NJSA 42:2C, the Revised Uniform New Jersey Limited Liability Company
Act, the undersigned company hereby grants authority or limits the authority of the position(s) or person(s)
noted. The filer is responsible for ensuring strict compliance with NJSA 42:2C, the Revised Uniform New
Jersey Limited Liability Company Act.
1. Name of Limited Liability Company: __________________________________________________
2. Business ID Number: ______________________________________________________________
The undersigned represents that this filing complies with State law as detailed in NJSA 42:2C and they
are authorized to sign this form on behalf of the Limited Liability Company
Signature: ____________________________________ Date: _________________________
Name: _______________________________________ Title: _________________________
To file electronically:
1. Enter the information requested below and sign by typing your name in the signature field. The form can only be filled in using the free Adobe
Acrobat Reader 9.1 or greater. (See the pages following this form for field by field instructions, and notes on delivery and processing of work requests.)
2. Click the "Add Attachments" button to add attachments if required (Check the field by field instructions to see if you must include an attachment(s)).
3. After the form has been filled in properly, please save a copy to your computer so that you can upload the form to the State of New Jersey Division of
Revenue & Enterprise Services Central Forms Repository Web application by following the instructions in the next step.
4. Click the "Open the Central Forms Repository Home Page to start the Form Submission Process" button at the bottom of the form.
(This action will launch the State of New Jersey Division of Revenue & Enterprise Services Central Forms Repository Web application. If you have not
created an account in the application, you will need to do so before using the online Web application. Once your account is created, please login to the
application and follow the instructions for submitting your form and payment online.)
New Jersey Division of Revenue & Enterprise Services
Title 42:2C-28
6. Indicate the authority, or limitation on the authority, to enter into other transactions on behalf of, or
5. Indicate the authority, or limitation on the authority, to execute an instrument transferring real property
4. Name(s) of position(s) or person(s): __________________________________________________
3. Name and Address of Registered Agent:
Agent Name: _____________________________________________________________________
Agent Address: ___________________________________________________________________
City: ____________________________
State: __________________
Zip Code: __________
___________________________________________________________________________________
held in the name of the company:
Person(s):____________________________________________________________________________
Position(s):___________________________________________________________________________
otherwise act for or bind, the company:
Person (s):___________________________________________________________________________
Positions(s):__________________________________________________________________________
Add Attachments
Open the Central Forms Repository Home Page to start the Form Submission Process
Instructions for Form L-115
AMENDMENT OF STATEMENT OF AUTHORITY
LIMITED LIABILITY COMPANY
NJSA 42:2C-28
STATUTORY FEE:
$75
The MANDATORY fields are:
Field #1 -- Name of Limited Liability Company:
List the name as it appears on the records of the State Treasurer.
Field #2 -- Business ID Number:
Provide the 10-digit business identification number issued by the State of New Jersey
EXECUTION (Signature/Date)
An authorized representative must sign and date the form.
**********
L-115 Rev. 11/2014
Field #6 -- For each named position/person, indicate the authority, or limitation on the authority, to
Field #5 -- For each named position/person, indicate the authority, or limitation on the authority, to
Field #3 -- Name and address of the Registered Agent:
Field #4 -- Enter the name(s) of position(s) or person(s):
execute an instrument transferring real property held in the name of the company.
enter into other transactions on behalf of, or otherwise act for or bind, the company.
