Schedule G For First-Year Irp Applicants Or Business Operational Changes Form - Illinois Secretary Of State Page 2
Download a blank fillable Schedule G For First-Year Irp Applicants Or Business Operational Changes Form - Illinois Secretary Of State in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Schedule G For First-Year Irp Applicants Or Business Operational Changes Form - Illinois Secretary Of State with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
46. Is your vehicle(s) presently leased to any individual or company? ............................................................
YES
NO
If yes, Name, Address and Phone Number of Lessee: ___________________________________________________
______________________________________________________________________________________________
If you are not presently leasing or leased to anyone but have inquired about potentially leasing to someone, indicate the
Name, Address, USDOT Number and Phone Number of the entity and list a contact person.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Part II, Business Ownership Information
Please explain about your business ownership and those persons associated with the operations, if any.
1. Business Type -
Individual or Proprietorship (includes Owner/Operator)
Partnership
Company
Corporation – IL Corporation Number or State of Incorporation if foreign: ___________________
A copy of a “Certificate of Good Standing” is required for a foreign corporation.
Limited Liability Company (LLC) - IL LLC Number or State if foreign: _____________________
A copy of a “Certificate of Good Standing” is required for a foreign LLC.
Other – Describe _____________________________________________________________
2. Please list the Name, Address and Phone Number of any person (including yourself), officer, partner, spouse, family
member, trustee, or other entity (including other business names or corporations) that have more than a 10% ownership
stake in this business:
1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
3. ________________________________________________________________________________________
4. ________________________________________________________________________________________
5. ________________________________________________________________________________________
Please attach additional sheets, if necessary.
3. Have any of the other named parties in Part II, #2 had IRP based in IL or any other Jurisdiction? …..…..
YES
NO
If yes, give Firm/Account Number(s) and Jurisdiction(s): ________________________________________________
4. Have any of the other named parties in Part II, #2 ever been denied registration by any Jurisdiction? ….
YES
NO
If yes, give Jurisdiction and explain: ________________________________________________________________
5. Have any of the named parties in Part II, #2 ever been audited for IRP by any Jurisdiction? …………….
YES
NO
If yes, approximate date/Jurisdiction: _______________________________________________________________
6. Is the business address a personal residence?
…………………………………………………………… ..
YES
NO
If yes, Name and relationship to registrant: __________________________________________________________
Part III, Driver Information
Please explain who will be operating your vehicles.
1. Are you the driver of the vehicle(s)? ………………………………………………………………………..…….
YES
NO
If yes, Driver’s License #___________________________ State of Issuance________________ CDL
YES
NO
Will you employ a fleet of drivers (more than yourself)? ………………………………………………….…….
YES
NO
If yes and more than one driver, list all potential driver information on an additional sheet.
2. Has any driver or potential driver listed had their license suspended or revoked? …….……………………
YES
NO
If yes, give Jurisdiction and explain: _________________________________________________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal