Affidavit Of Compliance For Service On Secretary Of State (Illinois)
This form is a notice of resignation of a registered agent in Illinois. The form provided here is simply a sample of what the actual Form BCA-5.15 looks like.
File # ________________________________
Form BCA-515
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
Remit payment in check or money order, payable to "Secretary of State."
-------------------------------
SUBMIT IN DUPLICATE
This space for use by Secretary of State
Date ________________________________
Filing Fee $10.00
Approved: ________________________________
-------------------------------
AFFIDAVIT OF COMPLIANCE FOR SERVICE ON SECRETARY OF STATE
1. Title of the case and number of the case:
first named plaintiff ]
v.
first named defendant ]
Number ______________
2. Name of the corporation being served: _______________________
3. Title of the court in which an action, suit or proceeding has been commenced: ______________________
4. Title of the instrument being served: _________________________
5. Basis for service on the Secretary of State (Check and complete appropriate box):
a. ____ The corporation's registered agent cannot with reasonable diligence be found at the registered office of record in Illinois.
b. ____ The corporation has failed to appoint and maintain a registered agent in Illinois.
c. ____ The corporation was dissolved on ___________________________ (Month & Day), _________ (Year); the conditions of paragraphs (a) and (b) above exist; and the action, suit or proceeding has been instituted or has affected the corporation within 5 years thereafter.
d. ____ The corporation's certificate of authority to transact business in Illinois has been (withdrawn)/(revoked)
on ________________________ (Month & Day), ___________ (Year).
e. ____ The corporation is a foreign corporation that has transacted business in Illinois without procuring a certificate of authority, contrary to the provisions of the Business Corporation Act of 1983.
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 undersigned affirms, under penalties of perjury, that the facts stated herein are true.
Signature of Affiant _________________________________________
Month & Day _______________________________, Year _________
Telephone Number _________________________________
RETURN TO: PLEASE TYPE OR PRINT CLEARLY
Name ____________________________________
Street ____________________________________
City/Town ____________________________________
-----------------------------
INSTRUCTIONS FOR FILLING OUT THIS FORM
-----------------------------
After complying with the reverse side, especially statement 5 and 6, service may then be made on the Secretary of State:
1. A copy of the process, notice or demand;
2. A copy of any papers to be served therewith;
3. An affidavit of compliance; $10.00 fee.
Following service on the Secretary of State, another effort must be made to serve the corporation by Certified or regular mail. This attempted service must include items 1 and 2 of the above in addition to a notice of service on the Secretary of State.
The effort to serve the corporation shall be:
1. At the last registered office of the corporation as shown on the records of the Secretary of State;
AND
2. At such address the use of which the person instituting the action, suit or proceeding knows, or on the basis of reasonable inquiry has reason to believe, is most likely to result in actual notice.
This affidavit will be stamped with the date of filing and returned to the affiant as the only proof of filing.