BCS/CD-901 (Rev. 04/11) MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BUREAU OF COMMERCIAL SERVICES CORPORATION DIVISION Telephone: (517) 241-6470 MICH-ELF APPLICATION Fax completed form to: (517) 241-6445 (Do not submit any other documents with this form. Once your account is built or updated, you will receive instructions by fax on where to submit your documents.) Complete this form to participate in the MICH-ELF filing program or update your account. First time MICH-ELF users requesting expedited service must obtain a MICH-ELF filer number prior to submitting a document for expedited service. Changes to information on MICH-ELF user's account must be submitted before requesting expedited service. New Application Update MICH-ELF Filer Number Applicant Phone Number Street Address Fax Number Required City State ZIP Code If any changes are being made to credit card information, please complete all information below. Credit Card (Check One) VISA MASTERCARD Card Number Expiration Date Card Issued To (Name of Person) Cardholders Billing Street Address Contact Person City State ZIP Code Phone Number LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. American LegalNet, Inc. www.FormsWorkFlow.com