Form Llc-5.47 - Illinois Limited Liability Company Act Statement Of Correction
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Illinois
LLC-5.47
This space for use by
Form
Secretary of State
Limited Liability Company Act
July 2003
Statement of Correction
Jesse White
Secretary of State
Department of Business Services
SUBMIT IN DUPLICATE
Liability Limitation Division
Must be typewritten
Room 351, Howlett Building
Springfield, IL 62756
This space for use by Secretary of State
Payment must be made by business
Date
firm check payable to Secretary of
Assigned File #
State. (If check is returned for any
Filing Fee
$25.00
reason this filing will be void.
Approved:
1.
Limited Liability Company Name: _________________________________________________________
2.
State or Country of organization: __________________________________________________________
3.
Title of document to be corrected: _________________________________________________________
4.
Date erroneous document was filed by Secretary of State: _____________________________________
5.
Inaccuracy, error or defect:
(Briefly identify the error and explain how it occurred. Use reverse side or add one or more sheets of this size if necessary.)
6.
Corrected portion(s) of the document in corrected form:
(If there is not sufficient space to cover this point, use reverse side or add one or more sheets of this size.)
7.
I affirm, under the penalties of perjury, having the authority to sign hereto, that this statement of correction
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 34
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