1. Limited Liability Company name: __________________________________________________________________
2. State or country of organization: ____________________________________________________________________
3. Title of document to be corrected: _____________________________________________________________________
4. Date erroneous document filed by Secretary of State: ______________________________________________________
5. Inaccuracy, error or defect: __________________________________________________________________________
(Briefly identify the error and explain how it occurred. If more space is needed, use reverse side or attach additional sheets of this size.)
6. Corrected portion(s) of document in corrected form: ________________________________________________________
(If more space is needed, use reverse side or attach additional sheets of this size.)
7. I affirm, under the penalties of perjury, having the authority to sign hereto, that this Statement of Correction 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-5.47
July 2017
Illinois
Limited Liability Company Act
Statement of Correction
Printed by authority of the State of Illinois. January 2018 — 1 — LLC 34.4
SUBMIT IN DUPLICATE
Type or print clearly.
Filing Fee: $25
Approved:
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 may be made by check
payable to Secretary of State. If
check is returned for any reason this
f
iling will be void.
This space for use by Secretary of State.
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