Form Bca 2.10 (Mca) Articles Of Incorporation Medical Corporation Page 2
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25. OPTIONAL:
a. Number of directors constituting the initial board of directors of the Corporation: ____________________________
b. Names and addresses of persons who will serve as directors until the first annual meeting of shareholders or until
their successors are elected and qualify:
Name
Address
City, State, ZIP
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
6. OPTIONAL:
a. Estimated value of all property to be owned by the Corporation for the follow-
ing year wherever located:
$___________________________
b. Estimated value of the property to be located within the State of Illinois dur-
ing the following year:
$___________________________
c. Estimated gross amount of business that will be transacted by the corpora-
tion during the following year:
$___________________________
d. Estimated gross amount of business that will be transacted from places of
business in the State of Illinois during the following year:
$___________________________
7. OPTIONAL: OTHER PROVISIONS
Attach a separate sheet of this size for any other provision to be included in the Articles of Incorporation (e.g., author-
izing preemptive rights, denying cumulative voting, regulating internal affairs, voting majority requirements, fixing a dura-
tion other than perpetual, etc.).
8. NAME(S) & ADDRESS(ES) OF INCORPORATOR(S)
The undersigned incorporator(s) hereby declare(s), under penalties of perjury, that the statements made in the forego-
ing Articles of Incorporation are true and correct.
Dated ________________________________ , ______
Month & Day
Year
Signature and Name
Address
1. ___________________________________________
1. ___________________________________________
Signature
Street
1.
___________________________________________
1.
___________________________________________
Name (type or print)
City/Town
State
ZIP Code
2. ___________________________________________
2. ___________________________________________
Signature
Street
1.
___________________________________________
1.
___________________________________________
Name (type or print)
City/Town
State
ZIP Code
3. ___________________________________________
3. ___________________________________________
Signature
Street
1.
___________________________________________
1.
___________________________________________
Name (type or print)
City/Town
State
ZIP Code
Signatures must be in BLACK INK on original document. Carbon copy, photocopy or rubber stamp signatures may only
be used on conformed copies. NOTE: The incorporator must be either one or more persons licensed pursuant to
the Medical Practice Act or an Illinois attorney.
Note 1: Fee Schedule
Note 2: Return to:
The initial franchise tax is assessed at the rate of 15/100 of 1 percent
_______________________________
($1.50 per $1,000) on the paid-in capital represented in this State.
Firm name
(Minimum initial franchise tax is $25.)
_______________________________
Attention
The filing fee is $150
_______________________________
Mailing Address
The minimum total due (franchise tax + filing fee) is $175.
_______________________________
City, State, ZIP Code
Printed by authority of the State of Illinois. August 2006 - 5M - C 322.2
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