1. Limited Liability Company name: ____________________________________________________________________
______________________________________________________________________________________________
2. State or country under the laws of which the company is organized: (check one)
❒ Illinois (domestic) ❒ Foreign (specify): ____________________________
3. Check this box ❒ if it is a Series of the Limited Liability Company that intends to adopt, change, cancel or renew an assumed
name.
Name of Series: ____________________________________________________________________________________
4. TO ADOPT: The Limited Liability Company or Series intends to adopt and transact business under the
assumed name of:_________________________________________________________________
5. TO CHANGE: (a) The above-named Limited Liability Company or Series intends to cease transacting business
under the assumed name of: ____________________________________________________
(b) and to commence transacting business under the new assumed name of: _________________
___________________________________________________________________________
6. TO CANCEL: The above-named Limited Liability Company or Series intends to cease transacting business under
the assumed name of: _____________________________________________________________
7. TO RENEW: The above-named Limited Liability Company or Series intends to renew the assumed name of:
________________________________________________________________________________
8. The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this Application to Adopt, Change,
Cancel or Renew an Assumed Name 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.
Form LLC-1.20
July 2017
Illinois
Limited Liability Company Act
Application to Adopt, Change, Cancel
or Renew an Assumed Name
Printed by authority of the State of Illinois. December 2017 — 1 — LLC 15.14
SUBMIT IN DUPLICATE
Type or print clearly.
Filing Fee (See Note): $
Approved:
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 #
(see note)
(see note)
(see note)
(see note)