Form Nfp 113.15 - Application For Authority To Conduct Affairs In Illinois (Foreign Corporations) - 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
Secretary of State
Department of Business Services
Springfield, IL 62756
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 Secretary of State.
____________________________________ File #______________________________
Filing Fee: $50
Approved: ___________
———— Submit in duplicate ———— Type or Print clearly in black ink ———— Do not write above this line ————
1. a. Corporate Name: _____________________________________________________________________________
b. Assumed Corporate Name (Complete only if the new corporate name is not available in this state.):
______________________________________________________________________________________________
By electing this assumed name, the Corporation hereby agrees NOT to use its corporate name in the transaction of
business in Illinois. Form NFP 104.15 is attached.
2. a. State or Country of Incorporation: _________________________________________________________________
b. Date of Incorporation: __________________________________________________________________________
c. Period of Duration: _____________________________________________________________________________
3. a. Address of Principal Office, wherever located: _______________________________________________________
____________________________________________________________________________________________
b. Address of Principal Office in Illinois: ______________________________________________________________
____________________________________________________________________________________________
4. Name and Address of Registered Agent and Registered Office in Illinois:
Registered Agent: _______________________________________________________________________________
First Name
Middle Name
Last Name
Registered Office: _______________________________________________________________________________
Number
Street
Suite # (P.O. Box alone is unacceptable)
Registered Office
_______________________________________________________________________________
City
ZIP Code
County
5. States and Countries in which Corporation is admitted or qualified to conduct affairs: __________________________
6. Names and respective addresses of Corporation’s officers and directors:
Street Address
City
State
ZIP
President
Secretary
Director
Director
Director
If there are additional officers or more than three directors, please attach list.
Printed by authority of the State of Illinois. June 2006 - 5M - C 160.14
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