Form 81 - Limited Liability Company Application printable pdf download

Form 81 - Limited Liability Company Application

LIMITED LIABILITY COMPANY APPLICATION

Office of Banks and Real Estate

500 E Monroe Street, Suite 200

Springfield, IL 62701

Real Estate Licensing 217/782-3414

Important Notice: Completion of this form is necessary to accomplish the requirements outlined in [Illinois Real Estate Act of 2000]. Disclosure

of this information is REQUIRED. Failure to comply may result in this form not being processed. This form has been approved by Forms

Management

Company Name

Date of Organization

FEIN Number

Address(Street, City, State, Zip Code)

Telephone Number

( _ _ _ ) _ _ _ - _ _ _ __

Name of Managing Broker

Managing Broker License Number

Firm License Number (If Applicable)

Name of Principal Filing Application

Business Address of the Registering Principal (Street, City,

State, Zip Code )

List All Members including individuals, Corporation(s), Partnership(s) or other entity that is

a member

. (If additional space is required please attach a separate listing.

Name/Entity

Illinois Real Estate

Percent of

Illinois Business Address (Street, City,

License Number

Ownership

State, Zip Code )

I hereby certify that I personally completed this form, that the information is true and correct, and that I am legally

authorized to sign for this firm. I further certify that each Member not licensed in the State of Illinois is not actively

participating in the brokerage business as defined in the Illinois Real Estate License Act of 2000, Sec. 5(15). I

understand that any change in Members or ownership interest shall require the LLC to file an application reflecting

those changes.

Signature of Managing Broker

Date

______________________________________________________

________________

IL 505-0514

Form 81 - Limited Liability Company Application