Form Nfp 113.15 - Application For Authority To Conduct Affairs In Illinois - Secretary Of State
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NFP 113.15
FORM
(rev. Dec. 2003)
APPLICATION FOR AUTHORITY
TO CONDUCT AFFAIRS IN
ILLINOIS (Foreign Corporations)
General Not For Profit Corporation Act
Jesse White, Secretary of State
Department of Business Services
Springfield, IL 62756
Telephone (217) 782-1834
Remit payment in the form of a cashier’s
check, certified check, money order
or an Illinois attorney’s or CPA’s check
payable to the Secretary of State.
_____________________________________ File #_________________________________
Filing Fee: $ 50.00
Approved:
——————————Submit in duplicate ———————Type or Print clearly in black ink———————Do not write above this line——————————
1.
(a) CORPORATE NAME: _______________________________________________________________
_________________________________________________________________________________
(Complete item 1(b) only if the corporate name is not available in this state.)
(b) ASSUMED CORPORATE NAME: ______________________________________________________
_________________________________________________________________________________
(By electing this assumed name, the corporation hereby agrees NOT to use its corporate name in the conducting
of affairs in Illinois. Form NFP 104.15 is attached.)
State or Country
Date of
2.
of Incorporation ____________ ;
Incorporation __________ ;
Period of Duration _____________
3.
(a) The address of its principal office, wherever located, is _____________________________________
_________________________________________________________________________________
(b) The address of its principal office in Illinois is _____________________________________________
_________________________________________________________________________________
4.
The name and address of its registered agent and its registered office in Illinois are:
Registered Agent
___________________________________________________________________
First Name
Middle Name
Last Name
Registered Office
___________________________________________________________________
Number
Street
Suite # (A P.O. box alone is not acceptable)
___________________________________________________________________
City
ZIP Code
County
5.
The states and countries in which it is admitted or qualified to conduct affairs are:
6.
The names and respective addresses of its officers and directors are:
No. & Street
City
State
ZIP
President
Secretary
Director
Director
Director
If there are additional officers or more than 3 directors, attach list.
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