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                                                                                                           FILE #
                                                                   Illinois 
Form                                               Limited Liability Company Act                           This space for use by Secretary of State.
May 2018LLC-45.5
Secretary of State                                 Application for Admission to
Department of Business    Services                          Transact Business
Limited Liability Division
501 S. Second St., Rm. 351                                  SUBMIT IN DUPLICATE
Springfield, IL  62756                                        Type or print clearly.
217-524-8008
www.ilsos.gov
Payment must be made by certified check,           Filing Fee: $150
cashier’s  check,  Illinois  attorney’s check,
C.P.A.’s check or money order payable to           Penalty: $ 
Secretary of State. If check is returned for       Approved:
any reason this filing will be void.

1. Limited Liability Company name (see Note 1): _____________________________________________________________________

2. Assumed name: ____________________________________________________________________________________________
                       (This item is only applicable if the company name in Item 1 is not available for use in Illinois, in which case form 
                       LLC 1.20 must be completed and submitted with this application.)

3. Jurisdiction of organization: __________________________________________________________________________________

4. Date of organization: ________________________________________________________________________________________

5. Period of duration: __________________________________________________________________________________________
                          (Enter perpetual unless there is a date of dissolution provided in the agreement, in which case enter that date.)
6. Address of the principal place of business: (P.O. Box alone or c/o is unacceptable.)

_________________________________________________________________________________________________________
            Number                                                 Street                                                 Suite #

  _________________________________________________________________________________________________________
              City                                                                       State                   ZIP

7. Registered agent: ___________________________________________________________________________________________
                                    First Name                                                 Middle Name       Last Name

  Registered office: ___________________________________________________________________________________________
(P.O. Box alone or c/o              Number                                                     Street            Suite #
is unacceptable.) 
                       ___________________________________________________________________________________________IL
                                              City                                                               ZIP

Note: The registered agent must reside in Illinois. If the agent is a business entity, it must be authorized to act as agent in this state.

8. If applicable, date on which company first conducted business in Illinois: _______________________________________________

                                                              (continued on back)

                                    Printed by authority of the State of Illinois. June 2018 — 1 — LLC 17.21

LLC-45.5

9.   Purpose(s) for which the company is organized and proposes to conduct business in Illinois (see Note 2): 
_________________________________________________________________________________________________________

      _________________________________________________________________________________________________________

10. The Limited Liability Company: (check one)
      n is managed by the manager(s)     or  n has management vested in the member(s):

11. List names and business addresses of all managers and any member with the authority of manager:
      _________________________________________________________________________________________________________

      __________________________________________________________________________________________________________

      _________________________________________________________________________________________________________

      _________________________________________________________________________________________________________

12. The Illinois Secretary of State is hereby appointed the agent of the Limited Liability Company for service of process under 
      circumstances set forth in subsection (b) of Section 1-50 of the Illinois Limited Liability Company Act.

13.  This application is accompanied by a Certificate of Good Standing or Existence, duly authenticated within the last 60
      days, by the officer of the state or country wherein the LLC is formed.

14. The undersigned affirms, under penalties of perjury, having authority to sign hereto, that this application for admission to transact
      business is to the best of my knowledge and belief, true, correct and complete.

                                                                     Dated:  ____________________________________________
                                                                                                Month, Day, Year

                                                                         _________________________________________________
                                                                                                    Signature

                                                                         _________________________________________________
                                                                                           Name and Title (type or print)

                                                                         _________________________________________________
                                                                                 If applicant is signing for a company or other entity, 
                                                                                           state name of company or entity.

Note 1: The name must contain the term Limited Liability Company, LLC or L.L.C. The name cannot contain any of the following terms:
“Corporation,” “Corp.” “Incorporated,” “Inc.,” “Ltd.,” “Co.,” “Limited Partnership” or “LP.” However, a limited liability company that will provide
services licensed by the Illinois Department of Financial and Professional Regulation must instead contain the term Professional Limited
Liability Company, PLLC or P.L.L.C. in the name.

Note 2: A professional limited liability company must state the specific professional service or related professional services to be rendered
by the professional limited liability company.