Illinois Department of Agriculture • Bureau of Warehouses
P.O. Box 19281 • Springfield, IL 62794-9281 • 217/782-2895 • TDD 217/524-6858 • Fax 217/524-7801
ANNUAL REPORT
AGRICULTURAL CO-OPERATIVE ACT
805 ILCS 315/
To remain in compliance with 805 ILCS 315/21 and to retain their authority to do business within the State of Illinois each
association formed under this Act shall prepare an annual report on forms to be furnished by the Director of Agriculture.
Filing is due six months after fiscal year-end.
Principal Place of Business (the principal mailing address where annual report is to be sent):
Legal Name of Company
DBA
(Additional name legally authorized to do business as)
Additional Address (Building name, suite number, mail stop, etc.)
E 911 Address (physical street location – required item)
U. S. Postal Address (P. O. Box, etc.)
City
State
County
Zip Code
Company’s Telephone Number
Fax Number
Contact Person
Contact’s Telephone Number and Extension
Contact’s E-mail Address
Company’s Internet Site
Principal Illinois Location (if the same as the principal place of business just enter “SAME”):
Additional Address (Building name, suite number, mail stop, etc.)
E 911 Address (physical street location – required item)
U. S. Postal Address (P. O. Box, etc.)
City
State
County
Zip Code
Contact Person for this location:
Contact’s Telephone Number and Extension
Contact’s E-mail Address
Contact’s Fax Number
Illinois Incorporation File Number (This number was given by the Secretary of State’s office when this company originally
filed their articles of incorporation or obtained their certificate or authority) ___________________
Note:
The articles of incorporation may be altered or amended at any regular meeting, or any special meeting called for that purpose. Amendments to the
articles of incorporation when so adopted shall be filed in the office of the Secretary of State. A copy shall also be sent to the Department of Agriculture.