LLC-12A - Attachment (REV 11/2020)
2020 California Secretary of State
bizfile.sos.ca.gov
Attachment to
Statement of Information
(Limited Liability Company)
LLC-12A
Attachment
Above Space For Office Use Only
A. Limited Liability Company Name (Enter the exact name on file w ith the California
Secretary of State.)
B. 12-Digit Secretary of State Entity (File) Num ber
C. State, Foreign Country, or Place of Organization (only if formed outside of
California)
D. List of Additional Manager(s) or Member(s) - If the manager/member is an individual, enter the individual’s name and address. If the
manager/member is an entity, enter the entitys name and address. Note: The LLC cannot serve as its ow n manager or member.
2a. First Name Do not complete Item 2b
Middle Name
Last Name
Suf fix
2b. Entity NameDo not complete Item 2a
2c. Address
State
Zip Code
3a. First Name Do not complete Item 3b
Middle Name
Last Name
Suf fix
3b. Entity NameDo not complete Item 3a
3c. Address
State
Zip Code
4a. First Name Do not complete Item 4b
Middle Name
Last Name
Suf fix
4b. Entity NameDo not complete Item 4a
4c. Address
State
Zip Code
5a. First NameDo not complete Item 5b
Middle Name
Last Name
Suf fix
5b. Entity NameDo not complete Item 5a
5c. Address
State
Zip Code
6a. First Name Do not complete Item 6b
Middle Name
Last Name
Suf fix
6b. Entity NameDo not complete Item 6a
6c. Address
State
Zip Code
7a. First Name Do not complete Item 7b
Middle Name
Last Name
Suf fix
7b. Entity NameDo not complete Item 7a
7c. Address
State
Zip Code
8a. First Name Do not complete Item 8b
Middle Name
Last Name
Suf fix
8b. Entity NameDo not complete Item 8a
8c. Address
State
Zip Code
Clear Form
Print Form