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                                                                                                           FILE #
Form                                                         Illinois 
August 2018LLC-50.1                           Limited Liability Company Act                                Due prior to:

Secretary of State                                           Annual Report                                 This space for use by Secretary of State.
Department of Business     Services
Limited Liability Division                      Type or print clearly.
501 S. Second St., Rm. 351 
Springfield, IL  62756                 Filing Fee:   $75
217-524-8008
www.ilsos.gov                          Series Fee, if required:
                                       Penalty:
Payment  may  be  made  by  check      Total:
payable to Secretary of State. If check
                                       Approved:
is returned for any reason this filing
will be void.

1. Limited Liability Company name: ____________________________________________________________________

   Registered agent:________________________________________________________________________________

   Registered office: _____________________________________________________________IL_________________
                       Number          Street                Suite           City                                         ZIP

2. State or country of organization: ________________________  Date organized in or admitted to Illinois: _____________

3. Address of principal place of business: (P.O. Box alone is unacceptable.)
   _______________________________________________________________________________________________
     Number                        Street                      Suite                 City, State                        ZIP

4. Names and business addresses of managers and any member with the authority of manager:
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
   ______________________________________________________________________________________________
   Name                                      Number & Street               City, State                                    ZIP
                                              (Add additional sheets of this size if more space is needed.)
5. Managers other than a natural person affirm their current existence.

6. Changes to the registered agent and/or registered office must be submitted on Form LLC-1.36/1.37.

7. I affirm, under penalties of perjury, having authority to sign thereto, that this Annual Report is to the best of my knowledge
   and belief, true, correct and complete.

                                                               Dated: ___________________________, ______________
   A late filing penalty of $100 will apply                                        Month/Day                                  Year
   if this report is not filed within 60 days
   after the due date.                                         ________________________________________________
                                                                                                           Signature 
                                                               ________________________________________________
                                                                                   Name and Title (type or print)
                                                               ________________________________________________
                                                                    If applicant is a company or other entity, state name of company or entity.
                                   Printed by authority of the State of Illinois. August 2018 — 1 — LLC 23.14