Illinois > Secretary Of State > Limited Liability Company
Affidavit Of Compliance For Service On Secretary Of State LLC-1.50 - Illinois
| Affidavit Of Compliance For Service On Secretary Of State Form. This is a Illinois form and can be used in Limited Liability Company Secretary Of State . |
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Form May 2012 LLC-1.50 Illinois Limited Liability Company Act FILE # This space for use by Secretary of State. 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. Affidavit of Compliance for Service on Secretary of State SUBMITINDUPLICATE Type or Print Clearly This space for use by Secretary of State. Filing Fee: $100 Approved: 1. Name of Limited Liability Company being served: ______________________________________________________ ______________________________________________________________________________________________ 2. Title of Case and Case Number: _________________________________ v. _________________________________ First Named Plaintiff Number: ___________________________ First Named Defendant 3. Title of Court in which an action, suit or proceeding has been commenced: __________________________________ 4. Title of Instrument being served: ____________________________________________________________________ 5. A Copy of the Process, Notice or Demand, together with any papers required by law to be delivered with service, are hereby attached. 6 Address to which the undersigned has caused a copy of the attached process, Notice or Demand to be sent by certified or registered mail: ____________________________________________________________________________ ______________________________________________________________________________________________ 7. The Secretary of State is irrevocably appointed as an agent of a Limited Liability Company upon the following basis: a. I The Limited Liability Companys registered agent cannot with reasonable diligence be found at the registered office in Illinois. b. I The Limited Liability Company has failed to appoint and maintain a registered agent in Illinois. 8. The undersigned affirms, under penalties of perjury, that the facts stated herein are true, correct and complete. ____________________________________________ Signature of Affiant ______________________________________ , ______. Month/Day Year ____________________________________________ Name (print) ( ) ______________________________________________ Telephone Number RETURNTO: (Please type or print clearly.) _____________________________________________________ Name _____________________________________________________ Street _____________________________________________________ City, State, ZIP Printed by authority of the State of Illinois. May 2012 -- 1 -- LLC 13.6 American LegalNet, Inc. www.FormsWorkFlow.com
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