Illinois Secretary of State
Securities Department
421 E. Capitol Ave., 2nd Floor
Springfield, IL 62701
217-782-2256
IL FORM LB15
Consent to Service of Process
for Corporations, Unincorporated
Associations and Individuals
KNOW ALL MEN BY THESE PRESENTS:
That for the purpose of authorizing noncriminal suits, actions or proceedings arising from the violation of any provision of the Illinois Loan
Brokers Act of 1995, to be commenced in any court of competent jurisdiction in the State of Illinois, in any county in which the plaintiff or
complainant resides, or in which the cause of action may have arisen; pursuant to and in compliance with Section 15-15 of said Act, the
undersigned consents, without power of revocation, that any and all noncriminal suits, actions or proceedings arising from the violation of any
provision of said Act, may be commenced against the undersigned in any court of competent jurisdiction and proper venue in the State of
Illinois, by service of process upon the Secretary of State of Illinois. The undersigned further consents that such service of process upon the
said Secretary of State shall be valid and binding upon the undersigned.
IF EXECUTED BY A CORPORATION
IN WITNESS WHEREOF, the undersigned has caused this irrevocable consent and power of attorney to be executed in its behalf and its seal to
be hereunto affixed by its officers thereunto duly authorized in the State of Illinois this day of , 20 .
(Corporate Seal)
Attest: By:
STATE OF:
COUNTY OF:
I, , a Notary Public in and for said County in the State aforesaid, do, hereby, certify that
and , personally known to me and personally
known to be respectively the President and Secretary of ,
and personally known to be the same persons who subscribed to the foregoing instrument as the President and Secretary of
, appeared before me this day in person and acknowledged that they signed,
sealed and delivered the said instrument for and on behalf of the said
as its free and voluntary act, for the uses and purposes therein set forth.
Given under my hand and notarial seal this day of , 20 .
(NOTARIAL SEAL)
Notary Public: My commission expires:
Printed by authority of the State of Illinois. November 2015 — 100 — SEC 328.1
Corporate Name
Secretary
Corporate Name
Corporate Name
Corporate Name
President