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Published by
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www.cyberdriveillinois.com
Printed by authority of the Secretary of State of Illinois - May 2011 - 1 - I-234
Print
Reset
OR ER FORM
$290.00
❑ Subscription to the Illinois Register (52 Issues)
(annually)
❑ New
❑ Renewal
$10.00
❑ Back Issues of the Illinois Register (Current Year Only)
(each)
Volume#____________Issue#__________Date __________
$200.00
❑ Microfiche sets of the Illinois Register 1977 - 2004
(per set)
Specify Year(s)____________________________________
$5.00
❑ Cumulative/Sections Affected Indices 2003 - 2010
(per set)
Specify Year(s)____________________________________
$
2.00
(
Processing fee for credit card purchases, if applicable)
TOTAL AMOUNT OF ORDER
$_______________
❑ Check
Make Checks Payable To:
Secretary of State
❑ Visa
❑ Master Card
❑ Discover
(There is a $2.00 Processing fee for credit card purchases.)
Card #: __________________________________ Expiration Dates:_______________
Signature: ________________________________
Fax Order To:
(217) 557-8919
Send Payment To:
Secretary of State
Department of Index
Administrative Code Division
111 E. Monroe St.
Springfield, IL 62756
Company Name:
Attention:
ID#:
Address:
City:
State:
Zip Code:
Telephone #:
Fax #:
E-Mail:
Jesse White
Published by
Secretary of State
l
www.cyberdriveillinois.com
Printed by authority of the Secretary of State of Illinois - May 2011 - 1 - I-234
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