Fillable FORM BCA 2.10 (MCA) (rev. Dec. 2003): ARTICLES (How to Start a Business)

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FORM BCA 2.10 (MCA) (rev. Dec. 2003): ARTICLES (How to Start a Business)

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FORM BCA 2.10 (MCA) (rev. Dec. 2003)
ARTICLES OF INCORPORATION
Medical Corporation
Secretary of State
Department of Business Services
501 S. Second St., Rm. 350
Springfield, IL 62756
217-782-9522
www.cyberdriveillinois.com
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.
See Note 1 on reverse to determine fees.
Filing Fee: $150 Franchise Tax $_____________ Total $____________ File #_________________________ Approved: ______
———— Submit in duplicate ———— Type or Print clearly in black ink ———— Do not write above this line ————
1. Corporate Name: ________________________________________________________________________________
______________________________________________________________________________________________
Must end with one of the following words or abbreviations: “Chartered,” “Limited,” “Ltd,” “Service Corporation” or “S.C.”
2. Initial Registered Agent: __________________________________________________________________________
First Name Middle Name Last Name
Initial Registered Office: __________________________________________________________________________
Number Street Suite # (P.O. Box alone is unacceptable)
Initial Registered Office: __________________________________________________________________________
City ZIP Code County
3. Purpose(s) for which the corporation is organized:
Medical Corporation: To own, operate and maintain an establishment for the study, diagnosis
and treatment of human ailments and injuries, whether physical or mental, and to promote medical,
surgical and scientific research and knowledge; provided that medical or surgical treatment, advice
or consultation will be given by employees of the corporation only if they are licensed pursuant to
the Medical Practice Act.
4. Paragraph 1: Authorized Shares, Issued Shares and Consideration Received:
Class Number of Shares Number of Shares Consideration to be
Authorized Proposed to be Issued Received Therefore
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
TOTAL = $______________________
Paragraph 2: The preferences, qualification, limitations, restrictions and special or relative rights in respect of the shares
of each class are:
For more space, attach additional sheets of this size.
Printed by authority of the State of Illinois. October 2015 - 1 - C 322.4
$
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5. OPTIONAL:
a. Number of directors constituting the initial board of directors of the Corporation: ____________________________
b. Names and addresses of persons who will serve as directors until the first annual meeting of shareholders or until
their successors are elected and qualify:
Name Address City, State, ZIP
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
6. OPTIONAL:
a. Estimated value of all property to be owned by the Corporation for the follow-
ing year wherever located:
b. Estimated value of the property to be located within the State of Illinois dur-
ing the following year:
c. Estimated gross amount of business that will be transacted by the corpora-
tion during the following year:
d. Estimated gross amount of business that will be transacted from places of
business in the State of Illinois during the following year:
7. OPTIONAL: OTHER PROVISIONS
Attach a separate sheet of this size for any other provision to be included in the Articles of Incorporation (e.g., author-
izing preemptive rights, denying cumulative voting, regulating internal affairs, voting majority requirements, fixing a dura-
tion other than perpetual, etc.).
8. NAME(S) & ADDRESS(ES) OF INCORPORATOR(S)
The undersigned incorporator(s) hereby declare(s), under penalties of perjury, that the statements made in the foregoing
Articles of Incorporation are true and correct.
Dated ________________________________ , ______
Month & Day Year
Signature and Name Address
1. ___________________________________________ 1. ___________________________________________
Signature Street
1. ___________________________________________ 1. ___________________________________________
Name (type or print) City/Town State ZIP Code
2. ___________________________________________ 2. ___________________________________________
Signature Street
1. ___________________________________________ 1. ___________________________________________
Name (type or print) City/Town State ZIP Code
3. ___________________________________________ 3. ___________________________________________
Signature Street
1. ___________________________________________ 1. ___________________________________________
Name (type or print) City/Town State ZIP Code
Signatures must be in BLACK INK on original document. Carbon copy, photocopy or rubber stamp signatures may only
be used on conformed copies. NOTE: The incorporator must be either one or more persons licensed pursuant to
the Medical Practice Act or an Illinois attorney.
Note 1: Fee Schedule
The initial franchise tax is assessed at the rate of 15/100 of 1 percent
($1.50 per $1,000) on the paid-in capital represented in this State.
(Minimum initial franchise tax is $25.)
The filing fee is $150
The minimum total due (franchise tax + filing fee) is $175.
$___________________________
$___________________________
$___________________________
$___________________________
Note 2: Return to:
_______________________________
Firm name
_______________________________
Attention
_______________________________
Mailing Address
_______________________________
City, State, ZIP Code
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FORM BCA 2.10 (MCA) (rev. Dec. 2003): ARTICLES (How to Start a Business)

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Completed 29 July 2020

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