Form Llc-5.47 - Statement Of Correction
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LLC-5.47
Illinois
FILE #
Form
Limited Liability Company Act
This space for use by Secretary of State.
May 2012
Statement of Correction
Secretary of State
Department of Business Services
Limited Liability Division
SUBMIT IN DUPLICATE
501 S. Second St., Rm. 351
Springfield, IL 62756
Type or Print Clearly.
217-524-8008
This space for use by Secretary of State.
Payment may be made by check
payable to Secretary of State. If
Filing Fee: $25
check is returned for any reason this
Approved:
filing will be void.
1. Limited Liability Company Name:
__________________________________________________________________
2. State or Country of Organization:
__________________________________________________________________
3. Title of Document to be Corrected: _____________________________________________________________________
4. Date erroneous Document filed by Secretary of State: ______________________________________________________
5. Inaccuracy, Error or Defect:
(Briefly identify the error and explain how it occurred. If more space is needed, use reverse side or attach additional sheets of this size.)
Corrected portion(s) of Document in corrected form:
6.
(If more space is needed, use reverse side or attach additional sheets of this size.)
I affirm, under the penalties of perjury, having the authority to sign hereto, that this Statement of Correction is to the best of
7.
my knowledge and belief, true, correct and complete.
________________________________________________
Signature
________________________________________________
Name (type or print)
________________________________________________
If applicant is a company or other entity, state Name of Company
and whether it is a member or manager of the LLC.
Dated: ___________________________, ______________
Month/Day
Year
Printed by authority of the State of Illinois. May 2012 — 1 — LLC 34.2
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