Illinois Non Profit Corporation Annual Report Form

In Illinois, a condition for the renewal of a non-profit corporation’s business registration is the filing of an annual report. Prior submission, a check for the $10.00 filing fee must be attached. Report and fee must be submitted to the following address: _______________.Download

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Year:________________ File #:__________________
1. Corporation Name:  _____________________________________________________________________________
2. Registered Agent: ______________________________________________________________________________
Registered Office: ______________________________________________________________________________
City, IL, ZIP, County: ____________________________________________________________________________
3a. Date of Incorporation/Qualification:___________________      3b.    State of Incorporation: ____________________
4. Names and Addresses of Corporation's Officers and Directors:	
NAME OFFICE NUMBER & STREET CITY STATE ZIP	
President
Secretary
Treasurer
Director
Director
Director	
NOTE:List all officers and directors above or on an additional sheet. Illinois corporations must have three directors.
5. Brief statement of type of business the corporation is conducting:
6. Is this corporation a Condominium Associationas established under the Condominium Property Act? (check one)	
■■	Ye s	■■	No
Is this corporation a Cooperative Housing Corporationdefined in Section 216 of the Internal Revenue Code of 1954? 
(check one)	
■■	Ye s	■■	No
Is this corporation a Homeowner's Associationthat administers a common-interest community as defined in sub-
section (c)of Section 9-102 of the Code of Civil Procedure? (check one)	
■■	Ye s	■■	No
ITEM 6 MUST BE COMPLETED.Failure to answer any question on this form may result in a late penalty, involuntary dis-
solution or revocation.
7. Address, including street and number, of Corporation's Principal Office:
________________________________________________________________________________________________	
Number and Street City State ZIP Code	
Under penalties of perjury and as an authorized officer, I declare that this Annual Report, pursuant to the provisions of the General
Not for Profit Corporation Act, has been examined by me and is to the best of my knowledge and belief, true, correct and complete. 
8. BY: _________________________________________________________________________________________	
Authorized Officerʼs Signature Title Date	
DOMESTIC/FOREIGN CORPORATION
ANNUAL REPORT
General Not for Profit Corporation Act
Secretary of State Jesse White
Department of Business Services
501 S. Second St.
Springfield, IL  62756
217-782-7808
www.cyberdriveillinois.com	
ITEM 8 MUST BE SIGNED.	
♻Printed on recycled paper. Printed by authority of the State of Illinois. December 2011 — 5M — C 54.24	
Filing fee: $10 (If late, add $3 penalty fee.)

NOTICE	
Under the General Not For Profit Corporation Act, this Annual Report must be properly executed and filed in the Office of the
Secretary of State prior to the first day of the corporationʼs anniversary month each year. If filed on time, a $10 filing fee only
is required by statute. If filed later, a statutory $3 penalty fee must be added.
This Annual Report must be properly completed and submitted to the Office of the Secretary of State.
Item 1: In the event of a change of corporate name, the Articles of Amendment (Form NFP 110.30) must be filed.
Item 2: A registered agent and/or registered office may not be changed on an Annual Report. To change the registered agent
and/or registered office, Form NFP 105.10/105.20 must be filed with the Secretary of State. This form may be downloaded
at www.cyberdriveillinois.com (click Departments, Business Services, Publications and Forms).
• The information requested must be given as the date of the execution of this report.
• This report must be signed by an authorized officer of the corporation.
• If this report is not filed, the corporation, if domestic, is subject to dissolution, or if foreign, is subject to having the authority
revoked.
DEFINITIONS
• “Anniversary” means the day each year exactly one year or more years after:
(1) the date on the Articles of Incorporation issued under Section 102.15 of this Act, if a domestic corporation.
(2) the date on the Application for Authority issued under Section 113.20 of the Act, if a foreign corporation.
• “Anniversary month” means the month in which the anniversary of the corporation occurs.