Form Llc-45.25 - Amended Application For Admission
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Illinois
FILE #
LLC-45.25
Form
Limited Liability Company Act
This space for use by Secretary of State.
May 2012
Amended Application for Admission
Secretary of State
Department of Business Services
Limited Liability Division
SUBMIT IN DUPLICATE
501 S. Second St., Rm. 351
S U B M I T I N D U P L I C T E
T ype or Print Clearly
Springfield, IL 62756
217-524-8008
This space for use by Secretary of State.
Filing Fee: $150
Payment may be made by check
payable to Secretary of State. If
Approved:
check is returned for any reason this
filing will be void.
1. Limited Liability Company Name: _______________________________________________________________________________
2. This amended application is accompanied by a Certificate of Good Standing, a Certificate of Fact, or a copy of the Articles of
Amendment to the Articles of Organization, as evidence of any change, such document 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.
If none, so state.
3. Text of Amendment: _________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
_________________________________________________________________________________________________________
4. 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.
_________________________________________________________________
Signature (must comply with Section 5-45 of ILLCA)
_________________________________________________________________
Name and Title (type or print)
_________________________________________________________________
Name if a Company or other Entity and if a Member or Manager of the LLC
Dated: _________________________________________, _________________
Month/Day
Year
Printed by authority of the State of Illinois. May 2012 — 1 — LLC 5.9
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