Form Llc-50.15 - Limited Liability Company Act Penalty - Return To Good Standing
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Illinois
LLC-50.15
Form
Limited Liability Company Act
FILE #
July 2005
Penalty - Return to Good Standing
Secretary of State Jesse White
This space for use by Secretary of State.
Department of Business Services
SUBMIT IN DUPLICATE
Limited Liability Division
Must be typewritten
Room 351 Howlett Building
501 S. Second St.
This space for use by Secretary of State.
Springfield, IL 62756
Filing Fee:
Payment must be made by certified
Approved:
check, cashier's check, Illinois
attorney's C.P.A.'s check or money
order payable to Secretary of State.
1. Limited Liability Company Name:________________________________________________________________
_____________________________________________________________________________________
2. Penalties applicable to return the Limited Liability Company to good standing: (check and complete where appropriate)
a)
$300
Failure to file the annual report and pay the requisite fee prior to the first day of the anniversary month.
b)
$300
Failure to appoint and maintain a registered agent in Illinois as required.
c)
$100
For each year or fraction thereof beginning with the second year of deliquency until the filing of this document.
Total penalty amount (a, b and c): $ ____________________
3. I affirm, under penalties of perjury, having authority to sign hereto, that this penalty form is to the best of my knowledge
and belief, true, correct and complete.
________________________________ , _________ .
Dated
Month/Day
Year
_______________________________________________
Signature
_______________________________________________
Name and Title (type or print)
_______________________________________________
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. July 2005 –5M – LLC-7.6
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