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This space for use by
Illinois
LLC-45.25
Secretary of State
Form
Limited Liability Company Act
December 2003
Amended Application for Admission
Jesse White
Secretary of State
Filing Fee (See instructions below.)
Department of Business Services
Submit in Duplicate
Limited Liability Company Division
Must be typewritten
Rm. 351 Howlett Building
Springfield, IL 62756
This space for use by Secretary of State
Date:
Payment may be made by business
Assigned File #:
firm check payable to Secretary of State.
Filing Fee: $
(If check is returned for any reason this
Approved:
filing will be void.)
1.
Limited Liability Company name: __________________________________________________________________
____________________________________________________________________________________________
2.
File number assigned by the Secretary of State: ______________________________________________________
3.
This amended application is accompanied by a copy of the Articles of Amendment to the Articles of Organization,
as evidence of any change, such copy being duly authenticated by the proper officer of the state or country wherein
the Limited Liability Company is organized, which certification is not more than 60 days old.
4.
The text of the amendment is:
5.
I affirm, under penalties of perjury, having authority to sign hereto, that this amended application for admission is
to the best of my knowledge and belief, true, correct and complete.
Dated ________________ , _______
(Month/Day)
(Year)
__________________________________________________
(Signature)
__________________________________________________
(Type or print name and title)
__________________________________________________
(If applicant is a company or other entity, state name of company
and indicate whether it is a member or manager of the LLC.)
INSTRUCTIONS:
If the only amendment reported is a change in the registered agent and/or registered office, the filing fee is $35.
If other changes are reported, the filing fee is $150.
LLC-5.4
(5/04)