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FORM NFP 101.15(rev. Dec. 2003)
STATEMENT OF CORRECTION
General Not For Profit Corporation Act
Secretary of State
Department of Business Services
501 S. Second St., Rm. 350
Springfield, IL  62756
217-785-2237
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Remit payment in the form of a 
check or money order payable 
to Secretary of State.

____________________________________ File #_____________________________    Filing Fee: $25              Approved: ___________
________Submit in duplicate _________Type or Print clearly in black ink _________Do not write above this line ________

1. Corporate Name: ________________________________________________________________________________

2. State or Country of Incorporation:___________________________________________________________________

3. Title of Document to be corrected:___________________________________________________________________

4. Date erroneous document was filed by the Secretary of State:____________________________________________

5. Briefly identify the inaccuracy, error or defect to be corrected:

6. Corrected portion(s) of the document in like format: 
For more space, attach additional sheets of this size.

7. The undersigned corporation has caused this statement to be signed by a duly authorized officer who affirms, under
penalties of perjury, that the facts stated herein are true and correct. All signatures must be in BLACK INK                                              .

Dated _______________________________ ,  _____    ________________________________________________ 
                                 Month   Day                                  Year                                               Exact Name of Corporation

     ______________________________________
                          Any Authorized Officer’s Signature

     ______________________________________
                             Name and Title (type or print)

                               Printed by authority of the State of Illinois. January 2015 - 1 - C 224.10