Statement Of Correction Under The General Not For Profit Corporation Act {NFP-101.15}

FORM NFP 101.15 (rev. Dec. 2003) STATEMENT OF CORRECTION General Not For Profit Corporation Act Secretary of State Department of Business Services 501 S. Second St., Rm. 350 Springfield, IL 62756 217-785-2237 www.cyberdriveillinois.com Remit payment in the form of a check or money order payable to Secretary of State. Print Reset Save ____________________________________ File #_____________________________ ________ Submit in duplicate _________ Type or Print clearly in black ink _________ Do not write above this line ________ Filing Fee: $25 Approved: ___________ 1. Corporate Name: ________________________________________________________________________________ 2. State or Country of Incorporation: ___________________________________________________________________ 3. Title of Document to be corrected:___________________________________________________________________ 5. Briefly identify the inaccuracy, error or defect to be corrected: 4. Date erroneous document was filed by the Secretary of State: ____________________________________________ 6. Corrected portion(s) of the document in like format: For more space, attach additional sheets of this size. 7. The undersigned corporation has caused this statement to be signed by a duly authorized officer who affirms, under penalties of perjury, that the facts stated herein are true and correct. All signatures must be in BLACK INK. Dated _______________________________ , _____ Month Day Year Any Authorized Officer's Signature Name and Title (type or print) ______________________________________ ______________________________________ ________________________________________________ Exact Name of Corporation Printed by authority of the State of Illinois. January 2015 - 1 - C 224.10 American LegalNet, Inc. www.FormsWorkFlow.com