LLC-12: California Statement of Information (Limited Liability Company)

Enter the name of the limited liability company exactly as it appears on file with the California Secretary of State, including the entity ending (ex: “Jones & Company, LLC” or “Smith Construction, a Limited Liability Company”).

If your LLC is a registered foreign LLC using an alternate name in California, you must enter the complete alternate name.

Enter the Entity Number issued to the LLC by the California Secretary of State at the time of registration.

If formed outside of California, enter the state, foreign country or other place where the LLC is organized. If the LLC is formed in California, leave Item 3 blank.

The jurisdiction must match the Secretary of State's records.

Enter the complete street address, city, state and zip code of the LLC's principal office. Address must be a physical address. Do not enter a P.O. Box address, an “in care of” address, or abbreviate the name of the city.

If different from the address in Item 4a (Street Address of Principal Office), enter the complete mailing address, city, state and zip code of the LLC. The mailing address will be used for mailing purposes and may be a P.O. Box address or “in care of” an individual or entity. Do not abbreviate the name of the city.

If the LLC is formed in California, enter the complete street address, city and zip code of the office in California, if different from Item 4a. If the LLC is formed outside of California, enter the complete street address, city and zip code of the principle business office in California, if any. Address must be a physical address in California. Street Address of California Office, if Item 4a is not in California - Do not list a P.O. Box. If Item 4a is an address in California leave Item 4c blank and proceed to Item 5.

Manager(s) or Member(s) If no managers have been appointed or elected, provide the name and address of each member. At least one name and address must be listed.

If the manager/member is an individual, complete Items 5a and 5c (leave Item 5b blank).

b. Entity Name - Do not complete Item 5a

If the LLC has more than one manager or member, enter the name(s) and address(es) of the additional managers or members on Form LLC-12A.

Service of Process (Must provide either Individual OR Corporation.) You must provide information for either an individual OR a registered corporate agent, not both.

INDIVIDUAL - Complete Items 6a and 6b only. Must include agent's full name and California street address. Enter the name of the agent for service of process and the agent's complete California street address, city and zip code. Street Address (if agent is not a corporation) - Do not enter a P.O. Box

CORPORATION - Complete Item 6c only. Only include the name of the registered agent Corporation. Enter the name of the registered corporate agent exactly as registered in California. Do not complete Items 6a and 6b.

Briefly describe the general type of business that is the principal business activity of the LLC.

Chief Executive Officer, if elected or appointed Enter the name and complete business or residential address of the chief executive officer, if any.

Manager-managed California or manager-managed Out-of-State LLC: does any manager have an outstanding final judgment issued by the Division of Labor Standards Enforcement or a court of law, for which no appeal therefrom is pending, for the violation of any wage order or provision of the Labor Code?

Member-managed California LLC: does any managing member have an outstanding final judgment issued by the Division of Labor Standards Enforcement or court of law, for which no appeal therefrom is pending, for the violation of any wage order or provision of the Labor Code?

Out-of-State LLC that is not managed by a manager or managers: does any member have an outstanding final judgment issued by the Division of Labor Standards Enforcement or court of law, for which no appeal is pending, for the violation of any wage order or provision of the Labor Code?

If the answer to any of the questions is Yes, select the Yes option. Otherwise, select No.

Provide an email address to opt-in to receive entity related notifications, including Statement of Information reminders, by email rather than USPS mail. If no email address is provided, you will continue to receive notices and reminders by USPS mail. To change your option after filing, you must submit a new complete Statement of Information.

Type or print the date, the name and title of the person completing this form and sign where indicated.

By signing, I affirm under penalty of perjury that the information herein is true and correct and that I am authorized by California law to sign.

For faster service, this form can be filed online at bizfileOnline.sos.ca.gov. All Statements of Information for limited liability companies can be filed online using the bizfile Online portal.

The completed form along with the applicable fees can be mailed to Secretary of State, Statement of Information Unit, P.O. Box 944260, Sacramento, CA 94244-2600 or delivered in person (drop off) to the Sacramento office, 1500 11th Street, Sacramento, CA 95814.

This form is due within 90 days of initial registration and every two years thereafter. The initial filing is due 90 days from the entity's registration date. If the registration occurred in an even-numbered year, the periodic filing is due every even year. If the registration occurred in an odd-numbered year, the periodic filing is due every odd year. The filing period includes the registration month and the immediately preceding five (5) months.

Failure to file this Statement of Information by the due date will result in the assessment of a $250.00 penalty (checked October 31, 2026).

LLC-12 is the California Secretary of State Statement of Information (Limited Liability Company). Form LLC-12, if changes have been made: No Fee. A Statement of Information is submitted after the initial or required filing requirements have been met to update information including changes to the agent for service of process.

The filing fee is $20.00 and the optional certification fee is $5.00 (checked October 31, 2026).