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Foreign Corporation Annual Report Form. This is a Illinois form and can be use in Corporation Secretary Of State.
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Tags: Foreign Corporation Annual Report, Illinois Secretary Of State, Corporation
9.
STATE OF ILLINOIS
FOREIGN CORPORATION ANNUAL REPORT
YEAR OF:
File Prior to:
(Item 9 OR 10a OR 10b, whichever is applicable, MUST be completed.)
CORPORATION
FILE #: __________________
PLEASE TYPE OR PRINT CLEARLY IN BLACK INK
Amounts stated in parts (a) through (d) below are given for the 12-month period
ending __________________________________________ , _____________ .
Day
Month
Year
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, Form BCA-14.30 must be completed and submitted in the same envelope.
Value of the property (gross assets):
1.
(a) owned by the corporation, wherever located: ....................................................................................................................... (a) $
(b) of the corporation located within the State of Illinois: ............................................................................................................ (b) $
Gross amount of business transacted by the corporation:
(c) everywhere for the above period: .......................................................................................................................................... (c) $
Corporate Name:
Registered Agent:
Registered Office:
City, IL, ZIP Code:
County:
(d) at or from places of business in Illinois for the above period: ............................................................................................... (d) $
2.
Principal Address of Corporation: _______________________________________________________________________________________
Street
ALLOCATION FACTOR =
b+d
a+c
=
.
State
6 decimal places
ALLOCATION FACTOR = 1.00000 (Enter this figure on line 11b below.)
STOP: Item 9 or 10 must be completed before continuing to Item 11.
ANNUAL FRANCHISE TAX AND FEES
321
321
321
321
321
321
321
321
321
321
321
321
11b. ALLOCATION FACTOR (Enter from Item 9 or Item 10.) ....................................... b.
11c. ILLINOIS CAPITAL (Multiply line 11a by line 11b.) ................................................ c.
432
4321
4321
4321
1
4321
432
4321
1
4321
4321
432
4321
4321
4321
4321
4321
4321
4321
4321
1
4321
432
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
1
4321
11a. TOTAL PAID-IN CAPITAL (Enter amount from Item 7a;
if late, enter the greater of 7a or 7b.) ...................................................................... a.
3a.
Date Qualified To Do Business in Illinois: __________________________________________
4.
ZIP Code
State or Country of Incorporation: __________________________________________
3b.
Enter this figure on line 11b below.
10a. ❑ 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.
10b. ❑ The Corporation elects to pay franchise tax on the basis of 100% of its total Paid-in Capital.
11.
City
Names and Addresses of Officers and Directors:
NOTE: The names and addresses of ALL officers and directors must be entered in this item.
Month
OFFICE
President
Secretary
Treasurer
Director
Director
Director
NAME
Day
Year
NUMBER & STREET
CITY
5.
If 51% or more of stock is owned by a minority or female, please check appropriate box:
6.
Number of shares authorized and issued (as of
CLASS
SERIES
STATE
ZIP
❑ Minority Owned
❑ Female Owned
):
PAR VALUE
NUMBER AUTHORIZED
NUMBER ISSUED
11d1. Multiply line 11c by .001 (Round to nearest cent.) ................................................. d1.
11d2. ANNUAL FRANCHISE TAX (Enter amount from line d1, but not less than $25.) .................................................. d2.
11e1. If Annual Report is late, multiply line d2 by .10 ...................................................... e1.
11e2. If Annual Franchise Tax is late, multiply line d2 by .02 for each month
e2.
late or part thereof (minimum $1) ........................................................................................................
11e3. INTEREST & PENALTIES (Add lines e1 and e2.) ................................................................................................. e3.
11f.
+ 75.00
ANNUAL REPORT FILING FEE ($75) ................................................................................................................... 11f.
11g. TOTAL ANNUAL FRANCHISE TAX, FEES, INTEREST, PENALTIES DUE
(Add line d2 + line e3 + line f.) ................................................................................................................................ 11g.
IMPORTANT: If the amount in item 6 or 7a differs from the Secretary of State's records, Form BCA 14.30 must be completed.
.
7a.
Amount of Paid-in Capital (as of ______________________ ): $ __________________________
7b.
Paid-in Capital on record with Secretary of State: $ _____________________________________
8.
By ____________________________________________________________________________
Any Authorized Officer's Signature
Title
Date
Item 8 Must Be Signed.
(Paid-in Capital reflects the sum of the
Stated Capital and Paid-in surplus accounts.)
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.
MAKE CHECKS PAYABLE TO ILLINOIS SECRETARY OF STATE.
(Place corporate file number on check.)
RETURN TO:
Jesse White, Secretary of State
Department of Business Services • 501 S. Second St. • Springfield, IL 62756
217-782-7808 • www.cyberdriveillinois.com
IMPORTANT
If there have been changes in Items 6 or 7, Form BCA 14.30 must be executed and
submitted with this Annual Report in the same envelope.
Please Complete Reverse Side of This Report
PRESIDENT
SECRETARY
IF THE ABOVE OFFICERS’ NAMES AND ADDRESSES ARE MISSING OR HAVE
CHANGED, ENTER ONLY THE ADDITIONS OR CORRECTIONS BELOW.
PRESIDENT
SECRETARY
Printed by authority of the State of Illinois. October 2008 — 2.5M — C 288.5
File #
Name
Street Address
City
State
ZIP Code
Name
Street Address
City
State
ZIP Code
Printed by authority of the State of Illinois. October 2008 — 2.5M — C 288.5
American LegalNet, Inc.
www.FormsWorkFlow.com
9.
STATE OF ILLINOIS
FOREIGN CORPORATION ANNUAL REPORT
YEAR OF:
File Prior to:
(Item 9 OR 10a OR 10b, whichever is applicable, MUST be completed.)
CORPORATION
FILE #: __________________
PLEASE TYPE OR PRINT CLEARLY IN BLACK INK
Amounts stated in parts (a) through (d) below are given for the 12-month period
ending __________________________________________ , _____________ .
Day
Month
Year
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, Form BCA-14.30 must be completed and submitted in the same envelope.
Value of the property (gross assets):
1.
(a) owned by the corporation, wherever located: ....................................................................................................................... (a) $
(b) of the corporation located within the State of Illinois: ............................................................................................................ (b) $
Gross amount of business transacted by the corporation:
(c) everywhere for the above period: .......................................................................................................................................... (c) $
Corporate Name:
Registered Agent:
Registered Office:
City, IL, ZIP Code:
County:
(d) at or from places of business in Illinois for the above period: ............................................................................................... (d) $
2.
Principal Address of Corporation: _______________________________________________________________________________________
Street
ALLOCATION FACTOR =
b+d
a+c
=
.
State
6 decimal places
ALLOCATION FACTOR = 1.00000 (Enter this figure on line 11b below.)
STOP: Item 9 or 10 must be completed before continuing to Item 11.
ANNUAL FRANCHISE TAX AND FEES
321
321
321
321
321
321
321
321
321
321
321
321
11b. ALLOCATION FACTOR (Enter from Item 9 or Item 10.) ....................................... b.
11c. ILLINOIS CAPITAL (Multiply line 11a by line 11b.) ................................................ c.
432
4321
4321
4321
1
4321
432
4321
1
4321
4321
432
4321
4321
4321
4321
4321
4321
4321
4321
1
4321
432
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
4321
1
4321
11a. TOTAL PAID-IN CAPITAL (Enter amount from Item 7a;
if late, enter the greater of 7a or 7b.) ...................................................................... a.
3a.
Date Qualified To Do Business in Illinois: __________________________________________
4.
ZIP Code
State or Country of Incorporation: __________________________________________
3b.
Enter this figure on line 11b below.
10a. ❑ 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.
10b. ❑ The Corporation elects to pay franchise tax on the basis of 100% of its total Paid-in Capital.
11.
City
Names and Addresses of Officers and Directors:
NOTE: The names and addresses of ALL officers and directors must be entered in this item.
Month
OFFICE
President
Secretary
Treasurer
Director
Director
Director
NAME
Day
Year
NUMBER & STREET
CITY
5.
If 51% or more of stock is owned by a minority or female, please check appropriate box:
6.
Number of shares authorized and issued (as of
CLASS
SERIES
STATE
ZIP
❑ Minority Owned
❑ Female Owned
):
PAR VALUE
NUMBER AUTHORIZED
NUMBER ISSUED
11d1. Multiply line 11c by .001 (Round to nearest cent.) ................................................. d1.
11d2. ANNUAL FRANCHISE TAX (Enter amount from line d1, but not less than $25.) .................................................. d2.
11e1. If Annual Report is late, multiply line d2 by .10 ...................................................... e1.
11e2. If Annual Franchise Tax is late, multiply line d2 by .02 for each month
e2.
late or part thereof (minimum $1) ........................................................................................................
11e3. INTEREST & PENALTIES (Add lines e1 and e2.) ................................................................................................. e3.
11f.
+ 75.00
ANNUAL REPORT FILING FEE ($75) ................................................................................................................... 11f.
11g. TOTAL ANNUAL FRANCHISE TAX, FEES, INTEREST, PENALTIES DUE
(Add line d2 + line e3 + line f.) ................................................................................................................................ 11g.
IMPORTANT: If the amount in item 6 or 7a differs from the Secretary of State's records, Form BCA 14.30 must be completed.
.
7a.
Amount of Paid-in Capital (as of ______________________ ): $ __________________________
7b.
Paid-in Capital on record with Secretary of State: $ _____________________________________
8.
By ____________________________________________________________________________
Any Authorized Officer's Signature
Title
Date
Item 8 Must Be Signed.
(Paid-in Capital reflects the sum of the
Stated Capital and Paid-in surplus accounts.)
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.
MAKE CHECKS PAYABLE TO ILLINOIS SECRETARY OF STATE.
(Place corporate file number on check.)
RETURN TO:
Jesse White, Secretary of State
Department of Business Services • 501 S. Second St. • Springfield, IL 62756
217-782-7808 • www.cyberdriveillinois.com
IMPORTANT
If there have been changes in Items 6 or 7, Form BCA 14.30 must be executed and
submitted with this Annual Report in the same envelope.
Please Complete Reverse Side of This Report
PRESIDENT
SECRETARY
IF THE ABOVE OFFICERS’ NAMES AND ADDRESSES ARE MISSING OR HAVE
CHANGED, ENTER ONLY THE ADDITIONS OR CORRECTIONS BELOW.
PRESIDENT
SECRETARY
Printed by authority of the State of Illinois. October 2008 — 2.5M — C 288.5
American LegalNet, Inc.
www.FormsWorkFlow.com
File #
Name
Street Address
City
State
ZIP Code
Name
Street Address
City
State
ZIP Code
Printed by authority of the State of Illinois. October 2008 — 2.5M — C 288.5