1.
Limited Liability Company name: (see Note 1) _____________________________________________________________________
2.
Assumed name: ___________________________________________________________________________________________
This item is only applicable if the company name in Item 1 is not available for use in Illinois, in which case form LLC-
1.20 must be completed and submitted with this application.
3.
Jurisdiction of organization: ___________________________________________________________________________________
4.
Date of organization: ________________________________________________________________________________________
5.
Period of duration: ___________________________________________________________________________________________
Enter “Perpetual” unless there is a date of dissolution provided in the agreement, in which case enter that date.
6.
Address of the office required to be maintained in the jurisdiction of its organization or, if not required, of the principal place of
business: (P.O. Box alone or c/o is unacceptable.)
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
7.
Registered agent: __________________________________________________________________________________________
Registered office: ___________________________________________________________________________________________
_________________________________________________________________________________________________________
Note: The registered agent must reside in Illinois. If the agent is a business entity, it must be authorized to act as agent in this state.
8.
If applicable, date on which the company first conducted business in Illinois: ____________________________________________
Form
LLC-45.5(S)
May 2018
Illinois
Limited Liability Company Act
Application for Admission
to Transact Business
Number
Number
First Name
Middle Initial
Last Name
City/State
City
ZIP
ZIP
IL
Street
Street
Suite #
Suite #
Printed by authority of the State of Illinois. June 2018 1 — LLC 39.11
SUBMIT IN DUPLICATE
Type or print clearly.
(continued on back)
(P.O. Box alone or
c/o is unacceptable.)
Filing Fee: $400
Penalty: $
Approved:
Month, Day, Year
S
ecretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 351
Springfield, IL 62756
2
17-524-8008
www.cyberdriveillinois.com
Payment must be made by certified check,
c
ashier’s check, Illinois attorney’s check, C.P.A.s
c
heck or money order payable to Secretary of
S
tate. If check is returned for any reason this
f
iling will be void.
This space for use by Secretary of State.
F
ILE #
Print
Reset
9.
Purpose(s) for which the company is organized and proposes to conduct business in Illinois: (see Note 2) ____________________
_________________________________________________________________________________________________________
__________________________________________________________________________________________________________
_________________________________________________________________________________________________________
1
0.
T
he jurisdiction of organization permits the establishment of a series having separate rights, powers or duties and has limited the
liabilities of such series. Unless otherwise provided for in the operating agreement, the debts, liabilities and obligations incurred,
contracted for, or otherwise existing with respect to a particular series of the Limited Liability Company are enforceable against the
assets of such series only, and not against the assets of the Limited Liability Company generally or any other series thereof; and
n
one of the debts, liabilities, obligations and expenses incurred, contracted for, or otherwise existing with respect to the Limited
Liability Company generally or any other series thereof shall be enforceable against the assets of such series.
11.
Pursuant to Section 37-40 of the Limited Liability Company Act, a Certificate of Designation shall be filed for each series being
registered to do business in this State.
12.
The Limited Liability Company: (Check one.)
is managed by the manager(s) or
has management vested in the member(s).
13. List names and business addresses of all managers and any member with the authority of manager(s):
______________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
14.
The Illinois Secretary of State is hereby appointed the agent of the company for service of process under the circumstances set
forth in subsection (b) of Section 1-50 of the Illinois Limited Liability Company Act.
15.
This application is accompanied by a Certificate of Good Standing or Existence, duly authenticated within the last 60 days
by the officer of the state or country wherein the LLC is formed. If the Certificate of Good Standing or Existence does not
affirm the ability to establish series, this application also is accompanied by a duly authenticated copy of the Articles of
Organization as amended.
16.
The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this application for admission to transact
business is to the best of my knowledge and belief, true, correct and complete.
Dated: ___________________________, __________________
______________________________________________________
______________________________________________________
______________________________________________________
Note 1: The name must contain the term Limited Liability Company, LLC or L.L.C. The name cannot contain any of the following terms:
“Corporation,” “Corp.” “Incorporated,” “Inc.,” “Ltd.,” “Co.,” “Limited Partnership” or “LP.” A limited liability company that will provide
services licensed by the Illinois Department of Financial and Professional Regulation must instead contain the term Professional Limited
Liability Company, PLLC or P.L.L.C. in the name.
Note 2: A professional limited liability company must state the specific professional service or related professional services to be
rendered by the professional limited liability company.
L
LC-45.5(S)
Month/Day
Signature
Name and Title (type or print)
If applicant is signing for a company or other entity,
state name of company or entity.
Year