ANNUAL REPORT
FOR
GENERAL NOT FOR PROFIT CORPORATION ACT
FILE NO.
SECRETARY OF STATE OF ILLINOIS
ANNUAL REPORT
DO NOT WRITE IN THIS SPACE
Filing Fee $5.00
1.)
2.)
NOTE:
DO NOT ALTER ITEM 1.
Form NFP 105.10 must be filed in this office in order to change THE REGISTERED AGENT and/or REGISTERED
OFFICE.
3.)
The above corporation organized under the laws of the state of
, pursuant to the
provisions of “The General Not for Profit Corporation Act” of the State of Illinois, hereby makes the following report:
4.)
The names and respective residential addresses of its officers and directors are:
NAME
OFFICE
NUMBER & STREET
CITY
STATE
ZIP
President
Secretary
Treasurer
Director
Director
Director
NOTE: List all directors above or list them on an additional sheet: Illinois corporations must have three directors.
5.)
The following is a brief statement of the character of the affairs which the corporation is actually conducting:
6.)
Is this corporation a Condominium Association as established under the Condominium Property Act?
Yes
No
(Check One)
Is this corporation a Cooperative Housing Corporation defined in Section 216 of the Internal Revenue Code of 1954?
Yes
No
(Check One)
Is this a Homeowner's Association which administers a common-interest community as defined in subsection (c)
of Section 9-102 of the Code of Civil Procedure?
Yes
No
(Check One)
7.)
If a foreign corporation, the address of its principal office in the state of incorporation is:
(Number and Street)
(State or Country)
(Please read reverse side of this report before signing below)
Under the penalty of perjury and as an
8.)
BY ______________________________________________________________
authorized officer, I declare that this annual
(Authorized Officer's Signature)
(Title)
(Date)
report, pursuant to provisions of the Gen-
eral Not For Profit Corporation Act, has
been examined by me and is, to the best of
my knowledge and belief, true, correct, and
complete.
ITEM 8 MUST BE SIGNED
C-54.18