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Application For Registration, Renewal Or Cancellation Of Foreign Corporation Name (Illinois)

This form is to register, renew, or cancel a foreign corporate name in Illinois. The form provided here is simply a sample of what the actual Form BCA-4.25 looks like.

Form BCA-4.25

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

APPLICATION TO ADOPT, CHANGE OR CANCEL, AN ASSUMED CORPORATE NAME

Payment must be made by certified check, cashier's check or a money order, payable to "Secretary of State."

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File # ________________________________

SUBMIT IN DUPLICATE

This space for use by Secretary of State

Date ________________________________

Filing Fee $_______________________________

Approved: ________________________________


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APPLICATION FOR REGISTRATION, RENEWAL OR CANCELLATION OF FOREIGN CORPORATION NAME

1. CORPORATE NAME: ____________________________

2. STATE OR COUNTRY OF INCORPORATION: ____________________________

3. Date of incorporation: ____________________________

4. Business in which the corporation is engaged: ____________________________

5. Post office address of the corporation to which the Secretary of State may mail notices:

6. The corporation desires to register its corporate name pursuant to Section 4.25, and it is not transacting business in the State of Illinois at this time.

7. Attached to this application is a certificate setting forth that the corporation is in good standing under the laws of the state or country wherein it is organized, executed by the proper officer of the state or country wherein it is organized, which certificate shall not be more than ninety (90) days old.

8. Check the appropriate box:

____ The fee for registration is $50.

____ The fee for renewal is $50.

____ The fee for cancellation is $25.

9. Such registration or renewal of registration shall be effective from the date of filing by the Secretary of State until the first day of the twelfth month following such date.

10. The cancellation shall be effective upon filing with the Secretary of State.

11. The undersigned corporation has caused this statement to be signed by its duly authorized officers, each of whom affirms, under penalties of perjury, that the facts stated herein are true.

Dated ____________________________ (Month & Day), _________ (Year)

____________________________ (Exact Name of Corporation)

attested by ____________________________ (Signature of Secretary or Assistant Secretary)

____________________________ (Type or Print Name and Title)

by ____________________________ (Signature of President or Vice President)

____________________________ (Type or Print Name and Title)

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