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Get IL LB 15-10 2015-2024

-2256 Application to register with the Office of the Illinois Secretary of State, Securities Department, pursuant to the Illinois Loan Brokers Act of 1995. 1. Name of Applicant (if an individual or sole proprietor, state last name, first name and middle name): 2. Social Security Number or F.E.I.N.: 3. Telephone Number: 4. Name under which Loan Broker business primarily is conducted, if different: 5. Firm’s Main Address (If P.O. Box, must have legal address.): Include Addresses of all.

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