Bca 13 15 Form – Fill Out and Use This PDF

FORM BCA 13.15 (rev. July 2021)

APPLICATION FOR AUTHORITY TO

TRANSACT BUSINESS IN ILLINOIS

Business Corporation Act

Secretary of State

Department of Business Services 501 S. Second St., Rm. 350 Springfield, IL 62756 217-782-1834 www.cyberdriveillinois.com

Remit payment in the form of a cashier’s check, certified check, money order

or an Illinois attorney’s or CPA’s check payable to the Secretary of State.

SEE NOTE 1 CONCERNING PAYMENT. File #______________________________

Filing Fee: $___________ Franchise Tax: $___________ Penalty/Interest: $___________ Total: $___________ Approved: ________

——————Submit in duplicate —————Type or print clearly in black ink—————Do not write above this line—————

1.(a) CORPORATE NAME: _________________________________________________________________________________

(Complete item 1 (b) only if the corporate name is not available in this state.)

(b)ASSUMED CORPORATE NAME: ________________________________________________________________________

(By electing this assumed name, the corporation hereby agrees NOT to use its corporate name in the transaction of business in Illinois. Form BCA 4.15 is attached.)

2. State or Country	Date of	Period of
of Incorporation _________________;	Incorporation _________________;	Duration ______________________

	(If none, so state)
_______________________________________________	_________________________________________________
_______________________________________________	_________________________________________________
_______________________________________________	_________________________________________________

4. Name and address of the registered agent and registered office in Illinois.

Registered Agent:	_____________________________________________________________________________________
	First Name	Middle Initial	Last Name
Registered Office:	_____________________________________________________________________________________
	Number	Street	Suite #	(A P.O. Box alone
		IL		is not acceptable.)
	City	ZIP		County

5. States and countries in which it is admitted or qualified to transact business: (Include state of incorporation.)

6. Name and addresses of officers and directors: (If more than 3 directors and/or additional officers, attach list.)

NameNo. & StreetCityState ZIP

President

________________________________________________________________________________________________________

Secretary

________________________________________________________________________________________________________

Director

________________________________________________________________________________________________________

Director

________________________________________________________________________________________________________

Director

________________________________________________________________________________________________________

Printed by authority of the State of Illinois. July 2021 - 1 - C 171.20

7.The purpose or purposes for which it was organized which it proposes to pursue in the transaction of business in this state: (If not sufficient space to cover this point, add one or more sheets of this size.)

8.Authorized and issued shares:

			Number of Shares	Number of Shares
Class	Series	Par Value	Authorized	Issued

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

(If more, attach list)

9.Paid-in Capital: $ ________________________________

(“Paid-in Capital” replaces the terms Stated Capital & Paid-in Surplus and is equal to the total of these accounts.)

10.(a) Give an estimate of the total value of all the property* of the

corporation for the following year:	$ ________________________________________
(b) Give an estimate of the total value of all the property* of the
corporation for the following year that will be located in Illinois:	$ ________________________________________
(c) State the estimated total business of the corporation to be
transacted by it everywhere for the following year:	$ ________________________________________
(d) State the estimated annual business of the corporation to be
transacted by it at or from places of business in the State of
Illinois:	$ ________________________________________

11.Interrogatories: (Important - this section must be completed.)

(a)Is the corporation transacting business in this state at this time?

(b)If the answer to item 11(a) is yes, state the exact date on which it commenced to transact business in Illinois:

12.This application is accompanied by a certified copy of the articles of incorporation, as amended, duly authenticated, within the last ninety (90) days, by the proper officer of the state or country wherein the corporation is incorporated.

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

Dated ____________________________ , ____________		__________________________________________
(Month Day)	(Year)	(Exact Name of Corporation)

__________________________________________

(Any Authorized Officer’s Signature)

__________________________________________

(Print Name and Title)

*PROPERTY as used in this application shall apply to all property of the corporation, real, personal, tangible, intangible, or mixed without qualifications.

Note 1 — Payment in connection with this application must be in the form of a certified check, cashier’s check, Illinois attorney or CPA’s check or money order made payable to the “Secretary of State.” The minimum fee due upon qualification is $150. Any additional fees will be billed and must be paid before this application can be filed.

•Please see filing periods set forth below regarding the franchise tax exemption amount for each year. (Tax amount minus exemption amount. If a negative number, no franchise tax due.)

Franchise Tax Liability Exemption Amounts

FILING PERIOD EXEMPTION AMOUNT

After 1/1/21

Exemption $1,000.00

•The minimum total due (franchise tax + filing fee) is $150.