Fillable Form 5: LLC-45.5 Transact Business Application for Admission (Illinois Secretary of State)

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Form 5: LLC-45.5 Transact Business Application for Admission (Illinois Secretary of State)

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The Form 5: LLC-45.5 Transact Business Application for Admission (Illinois Secretary of State) form is 2 pages long and contains:

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1.
Limited Liability Company name (see Note 1): _____________________________________________________________________
2.
Assumed name: ____________________________________________________________________________________________
3.
Jurisdiction of organization: __________________________________________________________________________________
4.
Date of organization: ________________________________________________________________________________________
5.
Period of duration: __________________________________________________________________________________________
6.
Address of the principal place of business: (P.O. Box alone or c/o is unacceptable.)
_________________________________________________________________________________________________________
Number Street Suite #
_________________________________________________________________________________________________________
City State ZIP
7.
Registered agent: ___________________________________________________________________________________________
First Name Middle Name Last Name
Registered office: ___________________________________________________________________________________________
Number Street Suite #
___________________________________________________________________________________________
City ZIP
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 company first conducted business in Illinois: _______________________________________________
Form
LLC-45.5
May 2018
Printed by authority of the State of Illinois. June 2018 — 1 — LLC 17.21
(P.O. Box alone or c/o
is unacceptable.)
IL
(continued on back)
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SUBMIT IN DUPLICATE
Type or print clearly.
Illinois
Limited Liability Company Act
Application for Admission to
Transact Business
(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.)
(Enter perpetual unless there is a date of dissolution provided in the agreement, in which case enter that date.)
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,
cashier’s check, Illinois attorney’s check,
C.P.A.’s check or money order payable to
Secretary of State. If check is returned for
any reason this filing will be void.
This space for use by Secretary of State.
F
ILE #
Print
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9.
Purpose(s) for which the company is organized and proposes to conduct business in Illinois (see Note 2):
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
10.
The Limited Liability Company: (check one)
n
is managed by the manager(s) or
n
has management vested in the member(s):
11.
List names and business addresses of all managers and any member with the authority of manager:
_
________________________________________________________________________________________________________
__________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
12.
The Illinois Secretary of State is hereby appointed the agent of the Limited Liability Company for service of process under
circumstances set forth in subsection (b) of Section 1-50 of the Illinois Limited Liability Company Act.
13.
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.
14.
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: ____________________________________________
Month, Day, Year
_________________________________________________
Signature
_________________________________________________
Name and Title (type or print)
_________________________________________________
If applicant is signing for a company or other entity,
state name of company or entity.
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.” However, 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.
LLC-45.5
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Form 5: LLC-45.5 Transact Business Application for Admission (Illinois Secretary of State)

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Completed 10 May 2021

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