Fillable Form Nfp 101.15 - Statement Of Correction printable pdf download

Form Nfp 101.15 - Statement Of Correction

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NFP 101.15

FORM

(rev. Dec. 2003)

STATEMENT OF CORRECTION

General Not For Profit Corporation Act

Secretary of State

Department of Business Services

Springfield, IL 62756

217-785-2237

Remit payment in the form of a

check or money order payable

to Secretary of State.

____________________________________ File #______________________________

Filing Fee: $25

Approved: ___________

———— Submit in duplicate ———— Type or Print clearly in black ink ———— Do not write above this line ————

1. Corporate Name: ________________________________________________________________________________

2. State or Country of Incorporation: ___________________________________________________________________

3. Title of document to be corrected: ___________________________________________________________________

4. Date erroneous document was filed by the Secretary of State: ____________________________________________

5. Briefly identify the inaccuracy, error or defect to be corrected:

6. Corrected portion(s) of the document in like format:

For more space, attach additional sheets of this size.

7. The undersigned Corporation has caused this statement to be signed by a duly authorized officer who affirms, under

penalties of perjury, that the facts stated herein are true and correct. All signatures must be in BLACK INK.

Dated _______________________________ , _____

________________________________________________

Month & Day

Year

Exact Name of Corporation

______________________________________

Any Authorized Officer’s Signature

______________________________________

Name and Title (type or print)

Printed by authority of the State of Illinois. June 2006 - 1M - C 224.8

Form Nfp 101.15 - Statement Of Correction

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