Secretary of State LLC-12 20-E75406
Statement of Information
(Limited Liability Company) FILED
In the office of the Secretary of State
IMPORTANT — Read instructions before completing this form. of the State of California
Filing Fee – $20.00
NOV 24, 2020
Copy Fees – First page $1.00; each attachment page $0.50;
Certification Fee - $5.00 plus copy fees
This Space For Office Use Only
1. Limited Liability Company Name (Enter the exact name of the LLC. If you registered in California using an alternate name, see instructions.)
POWAY GYMNASTICS LLC
2. 12-Digit Secretary of State File Number 3. State, Foreign Country or Place of Organization (only if formed outside of California)
202032510374 CALIFORNIA
4. Business Addresses
a. Street Address of Principal Office - Do not list a P.O. Box City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
b. Mailing Address of LLC, if different than item 4a City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
c. Street Address of California Office, if Item 4a is not in California - Do not list a P.O. Box City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
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). If the manager/member is
5. Manager(s) or Member(s) an entity, complete Items 5b and 5c (leave Item 5a blank). Note: The LLC cannot serve as its own manager or member. If the LLC
has additional managers/members, enter the name(s) and addresses on Form LLC-12A (see instructions).
a. First Name, if an individual - Do not complete Item 5b Middle Name Last Name Suffix
Anthony Salmeri
b. Entity Name - Do not complete Item 5a
c. Address City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
6. Service of Process (Must provide either Individual OR Corporation.)
INDIVIDUAL – Complete Items 6a and 6b only. Must include agent’s full name and California street address.
a. California Agent's First Name (if agent is not a corporation) Middle Name Last Name Suffix
Anthony Salmeri
b. Street Address (if agent is not a corporation) - Do not enter a P.O. Box City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
CORPORATION – Complete Item 6c only. Only include the name of the registered agent Corporation.
c. California Registered Corporate Agent’s Name (if agent is a corporation) – Do not complete Item 6a or 6b
7. Type of Business
a. Describe the type of business or services of the Limited Liability Company
Athlete Training
8. Chief Executive Officer, if elected or appointed
a. First Name Middle Name Last Name Suffix
Anthony Salmeri
b. Address City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
9. The Information contained herein, including any attachments, is true and correct.
11/24/2020 Anthony Salmeri CEO
_____________________ ____________________________________________________________ _________________________ __________________________________
Date Type or Print Name of Person Completing the Form Title Signature
Return Address (Optional) (For communication from the Secretary of State related to this document, or if purchasing a copy of the filed document enter the name of a
person or company and the mailing address. This information will become public when filed. SEE INSTRUCTIONS BEFORE COMPLETING.)
Name:
Company:
Address:
City/State/Zip:
LLC-12 (REV 01/2017)
Page 1 of 2 2017 California Secretary of State
www.sos.ca.gov/business/be
Attachment to 20-E75406
LLC-12A
Statement of Information
Attachment
(Limited Liability Company)
A. Limited Liability Company Name
POWAY GYMNASTICS LLC
This Space For Office Use Only
B. 12-Digit Secretary of State File Number C. State or Place of Organization (only if formed outside of California)
202032510374 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 entity’s name and address. Note: The LLC cannot serve as its own manager or member.
First Name Middle Name Last Name Suffix
Tracy Salmeri
Entity Name
Address City (no abbreviations) State Zip Code
16403 Arena Dr Ramona CA 92065
First Name Middle Name Last Name Suffix
Entity Name
Address City (no abbreviations) State Zip Code
First Name Middle Name Last Name Suffix
Entity Name
Address City (no abbreviations) State Zip Code
First Name Middle Name Last Name Suffix
Entity Name
Address City (no abbreviations) State Zip Code
First Name Middle Name Last Name Suffix
Entity Name
Address City (no abbreviations) State Zip Code
First Name Middle Name Last Name Suffix
Entity Name
Address City (no abbreviations) State Zip Code
First Name Middle Name Last Name Suffix
Entity Name
Address City (no abbreviations) State Zip Code
LLC-12A - Attachment (EST 07/2016) Page 2 of 2 2016 California Secretary of State
www.sos.ca.gov/business/be
