Form Llc-1.20(D) - Assumed Name Renewal Application
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Illinois
LLC-1.20(d)
This space for use by
Form
Secretary of State
Limited Liability Company Act
January 2000
ASSUMED NAME RENEWAL APPLICATION
Jesse White
Secretary of State
Filing Fee: $300
Department of Business Services
Submit in Duplicate
Limited Liability Company Division
Must be typewritten
Room 351, Howlett Building
Springfield, IL 62756
This space for use by Secretary of State
Date
Payment may be made by business
Assigned File #
firm check payable to Secretary of State.
Filing Fee
$
(If check is returned for any reason this
Approved:
filing will be void.)
1. Limited Liability Company name: _________________________________________________________________
____________________________________________________________________________________________
2. File number assigned by the Secretary of State: _____________________________________________________
3. The state or country under the laws of which the limited liability company is organized is: (check one)
________ Illinois (domestic)
________ Foreign (specify): ______________________________
4. Date organized (if an Illinois limited liability company) or date authorized to transact business in Illinois (if a foreign
limited liability company):________________________________________________________________________ .
5. Assumed name to be renewed: __________________________________________________________________
___________________________________________________________________________________________ .
6. The right to use the assumed name shall be effective from the date this application is filed by the Secretary of State until
_________________________ , ______ , the first day of the limited liability company's anniversary month in the next
(Month/Day)
(Year)
year which is evenly divisible by five.
7. I affirm, under penalties of perjury, having authority to sign hereto, that this application to renew the assumed name is
to the best of my knowledge and belief, true, correct and complete.
Dated _______________________________ , ________ .
(Month/Day)
(Year)
(Signature)
(Type or print Name and Title)
(If applicant is a company or other entity, state name of company
and indicate whether it is a member or manager of the LLC.)
Printed by authority of the State of Illinois. April 2006 — 500 — LLC 18.2
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