a) Limited Liability Company Name to be reserved: ________________________________________________________
_______________________________________________________________________________________________
Name of Applicant: _________________________________________________________________________________
Address of Applicant: ________________________________________________________________________________
The undersigned hereby applies for reservation of the above listed Limited Liability Company name for a period of 90 . .
days. This document is optional and, once filed, it does not establish a Limited Liability Company.
Dated ________________________, _______. _____________________________________________
_____________________________________________
_____________________________________________
b) The undersigned __________________________________ hereby transfers to_______________________________
_____________________________________ the right to use the name ________________________________ for LLC
purposes in Illinois. This name was reserved on ____________________________ , _______ .
The undersigned affirms, under penalties of perjury, that the facts stated herein are true.
Dated ________________________, _______. _____________________________________________
_____________________________________________
_____________________________________________
Form LLC-1.15
May 2012
Illinois
Limited Liability Company Act
a) Application to Reserve a Name
b) Transfer of Reserved Name
c) Cancellation of Reserved Name
The LLC name must contain the words “Limited Liability Company”, L.L.C. or LLC and cannot contain the terms Corporation, Corp., Incorporated, Inc.,
Ltd., Co., Limited Partnership, or L.P.
Month & Day
Signature of Applicant
Name of Original Applicant
Name of Transferee
Address of Transferee
Name and Title (type or print)
If applicant is a Company or other Entity, state Name of Company.
Year
Month & Day
Year
Month/Day
Signature of Original Applicant
Name and Title (type or print)
If applicant is a Company or other Entity, state Name of Company.
Year
Printed by authority of the State of Illinois. December 2017 — 1 — LLC 16.9
This space for use by Secretary of State.
Filing Fee: a) $25 b) $25 c) $5
Approved:
SUBMIT IN DUPLICATE
Type or print clearly.
APPLICATION TO RESERVE A NAME
NOTICE OF TRANSFER OF RESERVED NAME
Secretary of State
Department of Business Services
Limited Liability Division
501 S. Second St., Rm. 351
Springfield, IL 62756
217-524-8008
www.cyberdriveillinois.com
Payment may be made by check
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.
FILE #
Number Street Suite City, State Zip Code
