Form Llc-1.36/1.37 - Statement Of Change Of Registered Agent And/or Registered Office - 2012 Page 2

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LLC-1.36/1.37
6. If the change to the registered agent or registered office is authorized by the members or managers, sign here.
(See Note 5 below.)
The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this statement to change the reg-
istered agent or address 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 the member or manager signing this document is a company or
other entity, state name of company and indicate whether it is a
member or manager of the Limited Liability Company.
If change of registered office by registered agent, sign here. (See Note 6 below.)
The undersigned, under penalties of perjury, affirms that the facts stated herein are true, correct and complete.
Dated _______________________________, ________________
Month/Day
Year
________________________________________________________
Signature of Registered Agent of Record
________________________________________________________
Name and Title (type or print)
If registered agent is a corporation,
name and title of officer who is signing on its behalf.
NOTES
1. A $300 penalty applies when the Limited Liability Company fails to appoint and maintain a registered agent in Illinois within
60 days of notification of the Secretary of State by the resigning registered agent.
2. The registered office may, but need not be, the same as the principal office of the Limited Liability Company; however,
the registered office and the office address of the registered agent must be the same.
3. The registered office must include an Illinois street or road address (P.O. Box alone is unacceptable).
4. A Limited Liability Company cannot act as its own registered agent.
5. Any change of registered agent or registered address effected by the Limited Liability Company must be authorized by
the members or managers.
6. The registered agent may report a change of the registered office address of the Limited Liability Company for which
he/she is a registered agent. When the agent reports such a change, this statement must be signed by the registered
agent. If a corporation is acting as the registered agent, a duly authorized officer of the corporation must sign this
statement.

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