Free Corporate Fax Transmittal Request Form For Certificates Of Good Standing And/Or Copies Of Document - Illinois

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FORM BCA 15.15 CORPORATE FAX TRANSMITTAL REQUEST FORM FOR CERTIFICATES OF GOOD STANDING AND/OR COPIES OF DOCUMENT Illinois Business Corporation Act Secretary of State Department of Business Services Corporations Division 501 S. Second St., Rm. 350 Springfield, IL 62756 www.cyberdriveillinois.com

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FAX: 217-524-8281
_____________________________ File #:______________________________ Date: ___________ Approved: ___________

1. Corporation Name: _______________________________________________________________________________ 2. Secretary of State File Number:_____________________________________________________________________
8 digits

Request for: Expedited Certificate of Good Standing ............................................................................................................$45 Expedited Certified Copy of Articles of Incorporation and all amendments (minimum)....................................$75 Expedited Certified Copy of Other Document (set forth below) (minimum)......................................................$75 ______________________________________________________________________________________________
Name of Document Date Filed

In addition to the above fees, an additional $2 processor fee is charged when paying by credit card. 3. Credit Card (select one): Visa Mastercard Discover American Express

_____________________________________________________________________
Name as it appears on card

_____________________________________________________________________
Account Number Expiration Date

4. Name and Daytime Phone Number of Contact Person: ______________________________________________________________________________________________
Name Telephone Number

5. Shipment method (select one): Regular Mail (Complete item 6a.) United Parcel Service (Complete item 6a & 6b.) Fax (Complete item 6c.) 6a. Send to: _____________________________________________________________________________________
First Name Number City Middle Name Street State Account Number Name Last Name Apt./Ste. # ZIP Code Account ZIP Code Fax Number

_____________________________________________________________________________________ _____________________________________________________________________________________ 6b. UPS Account Number: __________________________________________________________________________ 6c. Fax to: ________________________________________________________________________________________ Expedited requests will be sent out within 24 hours via the above selected method.

Printed by authority of the State of Illinois. September 2008 - 1 - C 341