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Notice Of Resignation Of Registered Agent (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

Remit payment in check or money order, payable to "Secretary of State."



This space for use by Secretary of State

Date ________________________________

Filing Fee $5.00

Approved: ________________________________



1. CORPORATE NAME: ____________________________

2. Name and address of registered agent and registered office as they appear on the records of the Office of the Secretary of State:

Registered Agent First Name ____________________________

Middle Name ____________________________

Last Name ____________________________

Registered Office Number ____________________________

Street ____________________________

Suite # (A P.O. Box alone is not acceptable) ____________________________

City ____________________________

ZIP Code ____________________________

County ____________________________

3. Effective date of resignation: ____________________________. (Not less than 30 days after its filing by the Secretary of State)

4. Address of the principal office of the corporation as such is known to the registered agent:

Number ____________________________

Street ____________________________

Suite # ____________________________

City ____________________________

ZIP Code ____________________________

County ____________________________

5. A copy of this notice has been sent to the principal office of the corporation at least 10 days prior to the date of its filing with the Secretary of State.

6. The undersigned affirms, under penalties of perjury, that the facts stated herein are true.

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

By ____________________________ (Signature of Principal Officer)

____________________________ (Type or Print Name)

By ____________________________ (Signature of Registered Agent)

____________________________ (Type or Print Name)

NOTE: If registered agent is an individual, this notice shall be signed by the registered agent.

If registered agent is a corporation, this notice shall be signed by a principal officer.

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