Form Llc-45.5 - Application For Admission To Transact Business
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Illinois
LLC-45.5
Form
Limited Liability Company Act
FILE #
November 2008
Application for Admission
Secretary of State Jesse White
to Transact Business
This space for use by Secretary of State.
Department of Business Services
Limited Liability Division
SUBMIT IN DUPLICATE
501 S. Second St., Rm. 351
Must be typewritten.
Springfield, IL 62756
217-524-8008
This space for use by Secretary of State.
Payment must be made by certified
Filing Fee: $500
check, cashier's check, Illinois attorney's
Penalty:
$
check, Illinois C.P.A.'s check or money
order payable to Secretary of State.
Approved:
1.
Limited Liability Company Name:___________________________________________________________________
Must comply with Section 1-10 of ILLCA or Item 2 below also applies.
2.
Assumed Name: _________________________________________________________________________________
By electing this Assumed Name, the Limited Liability Company hereby agrees not to use its Company Name in the
transaction of business in Illinois. Form LLC-120 is attached.
3.
Jurisdiction of Organization:_______________________________________________________________________
4.
Date of Organization:_____________________________________________________________________________
5.
Period of Duration:_______________________________________________________________________________
6.
Address, including County, of the Office required to be maintained in the jurisdiction of its organization or, if not required,
of the Principal Place of Business: (P.O. Box alone or c/o is unacceptable.)
_____________________________________________________________________________________________
Number
Street
Suite #
_____________________________________________________________________________________________
City/State
ZIP Code
County
7.
Registered Agent:_______________________________________________________________________________
First Name
Middle Name
Last Name
Registered Office:________________________________________________________________________________
Number
Street
Suite #
(P.O. Box alone or
c/o is unacceptable.)
Illinois
_______________________________________________________________________________
City
County
ZIP Code
8.
If applicable, Date on which Company first conducted business in Illinois: __________________________________
(continued on back)
Printed by authority of the State of Illinois. November 2008 — 1 — LLC-17.10
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