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Domestic Corporation Annual Report (Illinois)

This form is for a domestic corporation to file an annual report with the State of Illinois. The form provided here is simply a sample of what the actual Form BCA-2.88 looks like.

Form BCA-2.88

Jesse White
Secretary of State
Department of Business Services
Springfield, IL 62756
Telephone (217) 785-2237
(217) 785-6033
https://www.sos.state.il.us

STATE OF ILLINOIS
DOMESTIC CORPORATION ANNUAL REPORT

PLEASE TYPE OR PRINT CLEARLY IN BLACK INK

1.) NOTE: A Change in the registered agent and/or registered office may only be effected by filing form BCA-5.10/5.20. If there have been any changes in items 6. or 7a; the enclosed BCA-14.30 must be completed and submitted in the same envelope.

2.) CORPORATE NAME __________________________________,

REGISTERED AGENT __________________________________,

REGISTERED OFFICE __________________________________,

CITY __________________________________, IL,

ZIP CODE __________________________________

COUNTY __________________________________

3.) Date Incorporated: __________________________________

4.) The names and residential addresses of ALL officers & directors MUST be listed here!

OFFICE President NAME __________________________________

NUMBER & STREET __________________________________

CITY __________________________________

STATE __________________________________

ZIP __________________________________

OFFICE Secretary NAME __________________________________

NUMBER & STREET __________________________________

CITY __________________________________

STATE __________________________________

ZIP __________________________________

OFFICE Treasurer NAME __________________________________

NUMBER & STREET __________________________________

CITY __________________________________

STATE __________________________________

ZIP __________________________________

OFFICE Director NAME __________________________________

NUMBER & STREET __________________________________

CITY __________________________________

STATE __________________________________

ZIP __________________________________

OFFICE Director NAME __________________________________

NUMBER & STREET __________________________________

CITY __________________________________

STATE __________________________________

ZIP __________________________________

5.) If 51% or more of the stock is owned by a minority or female, please check appropriate box. ____ Minority Owned ____ Female Owned

6.) Number of shares authorized and issued (as of __________________________________):

CLASS __________________________________

SERIES __________________________________

PAR VALUE __________________________________

NUMBER AUTHORIZED __________________________________

NUMBER ISSUED __________________________________


CLASS __________________________________

SERIES __________________________________

PAR VALUE __________________________________

NUMBER AUTHORIZED __________________________________

NUMBER ISSUED __________________________________


CLASS __________________________________

SERIES __________________________________

PAR VALUE __________________________________

NUMBER AUTHORIZED __________________________________

NUMBER ISSUED __________________________________


IMPORTANT! Whenever the amount in item 6 or 7a differs from the Secretary of State's records, the enclosed BCA 14.30 must be completed.

7a.) The amount of paid-in capital as of _________________________

is: $__________________________

7b.) The Paid-in Capital on record with the Secretary of State

is: $__________________________

(Paid-in Capital reflects the sum of the stated Capital and Paid-in surplus accounts.)

ITEM 8 MUST BE SIGNED!

8.) Under the penalty of perjury and as an authorized officer, I declare that this annual report, pursuant to provisions of the Business Corporation Act, has been examined by me and is, to the best of my knowledge and belief, true, correct, and complete.

By __________________________________ (Any Authorized Officer's Signature)

__________________________________ (Title)

__________________________________ (Date)

RETURN TO:

Jesse White
Secretary of State
Department of Business Services
Springfield, IL 62756
Telephone (217) 782-7808
www.sos.state.il.us

PRESIDENT

SECRETARY

File No. __________________________________

IF THE ABOVE OFFICERS' NAMES AND ADDRESSES ARE MISSING OR HAVE CHANGED, ENTER ONLY THE ADDITIONS OR CORRECTIONS BELOW.

PRESIDENT NAME __________________________________

STREET ADDRESS __________________________________

CITY __________________________________

STATE __________________________________

ZIP CODE __________________________________


SECRETARY NAME __________________________________

STREET ADDRESS __________________________________

CITY __________________________________

STATE __________________________________

ZIP CODE __________________________________

ENTER FEDERAL EMPLOYER IDENTIFICATION NUMBER IF NOT PRINTED __________________________________

(Item 9, OR 10, (a.) OR 10, (b.) whichever is applicable, MUST be completed)


9. The amounts stated in parts (a) through (e) below are given for the twelve-month period ending _____________________, 20________.

The value of the property (gross assets)

(a) owned by the corporation, wherever located, was...................... (a) $______________________

(b) of the corporation located within the state of Illinois was........................................ (b) $______________________

The gross amount of business transacted by the corporation

(c) everywhere for the above period was ............................................ (c) $______________________

(d) at or from places of business in Illinois for the above period was........................................ (d) $______________________

Give the location of the principal places of business of the corporation in each state where authorized to transact business and the gross amount of business transacted in each state for the above period. (If necessary, attach a second sheet.)

ALLOCATION FACTOR + b + d over a + c = .________________ (6 decimal places) (Write this figure on line 11b below.)

10. (a.) ____ ALL property of the corporation is located in Illinois and ALL business of the corporation is transacted at or from places of business in Illinois.

(b.) ____ the corporation ELECTS to pay franchise tax on the basis of 100% of its total paid-in capital.

ALLOCATION FACTOR = 1.00000 (Write this figure on line 11b below.)

STOP! Item 9 or 10 must be completed before continuing To Item 11.

11. ANNUAL FRANCHISE TAX AND FEES

(a.) Total Paid-in Capital (Enter amount from Item 7a from the other side of report. If late, enter the greater of 7a or 7b.)................... (a) $______________________

(b.) ALLOCATION FACTOR (Enter from Item 9 or Item 10 above) ......................... (b) $______________________

(c.) ILLINOIS CAPITAL (Multiply line (a.) by Line (b.)..................... (c) $______________________

(d1.) Multiply line (c.) by .001 (Round to nearest cent) .................... (d1) $______________________

(d2.) ANNUAL FRANCHISE TAX (Enter amount from line (d1.), but not less than $25).......................................... (d2) $______________________

(e1.) If Annual Report is late, multiply line(d2.) by .10 ....................... (e1) $______________________

(e2.) If Annual Franchise Tax is late, multiply line (d2.) by .01 for each month late or part thereof (minimum $1.00) ................................................ (e2) $______________________

(e3.) INTEREST & PENALTIES (Add line (e1.) and line (e2.) ............ (e3) $______________________

(f.) ANNUAL REPORT FILING FEE ($25)............................................................................. (f) $25

(g.) TOTAL ANNUAL FRANCHISE TAX, FEES, INTEREST, & PENALTIES DUE (Add line (d2.) + line (e3.) + line (f.)........................................... (g) $______________________

MAKE CHECKS PAYABLE TO ILLINOIS SECRETARY OF STATE.

IMPORTANT!

If there have been changes in Item 6 or 7, the enclosed form BCA 14.30 must be executed and submitted with this annual report in the same envelope.

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