Filing fee: $10 (If late, add $3 penalty fee.) DOMESTIC/FOREIGN CORPORATION ANNUAL REPORT General Not for Profit Corporation Act Secretary of State Jesse White Department of Business Services 501 S. Second St. Springfield, IL 62756 217-782-7808 www.cyberdriveillinois.com Filing fee: $10 (If late, add $3 penalty fee.) DOMESTIC/FOREIGN CORPORATION ANNUAL REPORT General Not for Profit Corporation Act Secretary of State Jesse White Department of Business Services 501 S. Second St. Springfield, IL 62756 217-782-7808 www.cyberdriveillinois.com Year: ____________ File #:________________ Year: ____________ File #:________________ 1. Corporation Name: _______________________________________________________________________________ 1. Corporation Name: _______________________________________________________________________________ 2. Registered Agent: ____________________________ 2. Registered Agent: ____________________________ Registered Office: ____________________________ Registered Office: ____________________________ City, IL, ZIP, County: __________________________ City, IL, ZIP, County: __________________________ 3a. Date of Incorporation/Qualification: _______________ 4. Names and Addresses of Corporation's Officers and Directors: NAME OFFICE 3b. State of Incorporation: __________________________ NUMBER & STREET STATE Date of Incorporation/Qualification: _______________ 4. CITY 3a. Names and Addresses of Corporation's Officers and Directors: ZIP NAME OFFICE President Secretary Treasurer Director Director Director 3b. State of Incorporation: __________________________ NUMBER & STREET CITY STATE ZIP President Secretary Treasurer Director Director Director NOTE: List all officers and directors above or on an additional sheet. Illinois corporations must have three directors. NOTE: List all officers and directors above or on an additional sheet. Illinois corporations must have three directors. 5. Brief statement of type of business the corporation is conducting: 5. Brief statement of type of business the corporation is conducting: 6. Is this corporation a Condominium Association as established under the Condominium Property Act? (check one) Yes No 6. Is this corporation a Condominium Association as established under the Condominium Property Act? (check one) Yes No Is this corporation a Cooperative Housing Corporation defined in Section 216 of the Internal Revenue Code of 1954? (check one) Yes No Is this corporation a Cooperative Housing Corporation defined in Section 216 of the Internal Revenue Code of 1954? (check one) Yes No Is this corporation a Homeowner's Association that administers a common-interest community as defined in subsection (c) of Section 9-102 of the Code of Civil Procedure? (check one) Yes No Is this corporation a Homeowner's Association that administers a common-interest community as defined in subsection (c) of Section 9-102 of the Code of Civil Procedure? (check one) Yes No ITEM 6 MUST BE COMPLETED. Failure to answer any question on this form may result in a late penalty, involuntary dissolution or revocation. ITEM 6 MUST BE COMPLETED. Failure to answer any question on this form may result in a late penalty, involuntary dissolution or revocation. 7. 7. Address, including street and number, of Corporation's Principal Office: _________________________________________________________________________________________________ Number and Street City State Address, including street and number, of Corporation's Principal Office: _________________________________________________________________________________________________ ZIP Code Number and Street City State ZIP Code Under penalties of perjury and as an authorized officer, I declare that this Annual Report, pursuant to the provisions of the General Not for Profit Corporation Act, has been examined by me and is to the best of my knowledge and belief, true, correct and complete. Under penalties of perjury and as an authorized officer, I declare that this Annual Report, pursuant to the provisions of the General Not for Profit Corporation Act, has been examined by me and is to the best of my knowledge and belief, true, correct and complete. 8. 8. BY __________________________________________________________________________________________ Authorized Officer's Signature Title Date ITEM 8 MUST BE SIGNED. Printed on recycled paper. Printed by authority of the State of Illinois. May 2008 — 5M — C-54.24 BY __________________________________________________________________________________________ Authorized Officer's Signature Title ITEM 8 MUST BE SIGNED. American LegalNet, Inc. www.FormsWorkflow.com Printed on recycled paper. Printed by authority of the State of Illinois. May 2008 — 5M — C-54.24 Date NOTICE NOTICE Under the General Not for Profit Corporation Act, this Annual Report must be properly executed and filed in the Office of the Secretary of State prior to the first day of the corporation's anniversary month each year. If filed on time, a $10 filing fee only is required by statute. If filed later, a statutory $3 penalty fee must be added. Under the General Not for Profit Corporation Act, this Annual Report must be properly executed and filed in the Office of the Secretary of State prior to the first day of the corporation's anniversary month each year. If filed on time, a $10 filing fee only is required by statute. If filed later, a statutory $3 penalty fee must be added. This Annual Report must be properly completed and submitted to the Office of the Secretary of State. This Annual Report must be properly completed and submitted to the Office of the Secretary of State. Item 1: In the event of a change of corporate name, the Articles of Amendment (Form NFP 110.30) must be filed. Item 1: In the event of a change of corporate name, the Articles of Amendment (Form NFP 110.30) must be filed. Item 2: A registered agent and/or registered office may not be changed on an Annual Report. To change the registered agent and/or registered office, Form NFP 105.10/105.20 must be filed with the Secretary of State. This form may be downloaded at www.cyberdriveillinois.com (click Departments, Business Services, Publications and Forms). Item 2: A registered agent and/or registered office may not be changed on an Annual Report. To change the registered agent and/or registered office, Form NFP 105.10/105.20 must be filed with the Secretary of State. This form may be downloaded at www.cyberdriveillinois.com (click Departments, Business Services, Publications and Forms). • The information requested must be given as the date of the execution of this report. • The information requested must be given as the date of the execution of this report. • This report must be signed by an authorized officer of the corporation. • This report must be signed by an authorized officer of the corporation. • If this report is not filed, the corporation, if domestic, is subject to dissolution, or if foreign, is subject to having its authority revoked. • If this report is not filed, the corporation, if domestic, is subject to dissolution, or if foreign, is subject to having its authority revoked. DEFINITIONS • “Anniversary” means the day each year exactly one year or more years after: (1) the date on the Articles of Incorporation issued under Section 102.15 of this Act, if a domestic corporation. (2) the date on the Application for Authority issued under Section 113.20 of the Act, if a foreign corporation. DEFINITIONS • “Anniversary” means the day each year exactly one year or more years after: (1) the date on the Articles of Incorporation issued under Section 102.15 of this Act, if a domestic corporation. (2) the date on the Application for Authority issued under Section 113.20 of the Act, if a foreign corporation. • “Anniversary month” means the month in which the anniversary of the corporation occurs. • “Anniversary month” means the month in which the anniversary of the corporation occurs. Printed on recycled paper. Printed by authority of the State of Illinois. May 2008 — 5M — C-54.24 Printed on recycled paper. Printed by authority of the State of Illinois. May 2008 — 5M — C-54.24 American LegalNet, Inc. www.FormsWorkflow.com