Form Llc-1.50 - Affidavit Of Compliance For Service On Secretary Of State - 2013
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Illinois Limited Liability Company Act
LLC-1.50
Form
This space for use by Secretary of State.
Affidavit of Compliance for
September 2013
Service on Secretary of State
Secretary of State
Department of Business Services
Limited Liability Division
SUBMIT IN DUPLICATE
501 S. Second St., Rm. 351
Type or Print Clearly
Springfield, IL 62756
217-524-8008
This space for use by Secretary of State.
Filing Fee: $100
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. Name of Limited Liability Company being served: ______________________________________________________
______________________________________________________________________________________________
2. Title of Case and Case Number:
_________________________________
First Named Plaintiff
v.
Number: ___________________________
_________________________________
First Named Defendant
3. Title of Court in which an action, suit or proceeding has been commenced: __________________________________
4. Title of Instrument being served: ____________________________________________________________________
5. A Copy of the Process, Notice or Demand, together with any papers required by law to be delivered with service, are
hereby attached.
6 Address to which the undersigned has caused a copy of the attached process, Notice or Demand to be sent by certi-
fied or registered mail: ____________________________________________________________________________
______________________________________________________________________________________________
7. The Secretary of State is irrevocably appointed as an agent of a Limited Liability Company upon the following basis:
a.
The Limited Liability Company’s registered agent cannot with reasonable diligence be found at the registered
office in Illinois.
b.
The Limited Liability Company has failed to appoint and maintain a registered agent in Illinois.
c.
The Limited Liability Company was dissolved on _________________________; the conditions of paragraphs
Month, Day, Year
a and b above exist; and the action, suitor preceding against or affecting the company has been instituted.
d.
The Limited Liability Company has been dissolved on _________________________; the conditions of a. or
Month, Day, Year
b. above exist, and a criminal proceeding against or affecting the company has been instituted.
e.
The Limited Liability Company is a foreign limited liability company admitted to transact business in Illinois
that has been revoked or withdrawn on __________________________.
Month, Day, Year
8. The undersigned affirms, under penalties of perjury, that the facts stated herein are true, correct and complete.
____________________________________________
______________________________________ , ______.
Signature of Affiant
Month/Day
Year
____________________________________________
Name (print)
(
)
______________________________________________
Telephone Number
RETURN TO: (Please type or print clearly.)
_____________________________________________________
Name
_____________________________________________________
Street
_____________________________________________________
City, State, ZIP
Printed by authority of the State of Illinois. September 2013 — 1 — LLC 13.7
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