Document processing fee If document is filed on paper $150.00 If document is filed electronically Currently Not Available Fees & forms/cover sheets are subject to change. To file electronically, access instructions for this form/cover sheet and other information or print copies of filed documents, visit www.sos.state.co.us and select Business. Paper documents must be typewritten or machine printed. ABOVE SPACE FOR OFFICE USE ONLY Statement of Election filed pursuant to 7-90-301, et seq. and §7-137-202 of the Colorado Revised Statutes (C.R.S) ID number: 1. Entity name: _____________________ ______________________________________________________ 2. The corporate entity has elected to accept articles 121-137 of title 7, C.R.S. All required reports have been or will be filed and all fees, taxes and penalties due to the state of Colorado accruing under any law to which the corporate entity heretofore has been subject have been paid. 3. If there are members or stockholders entitled to vote thereon, mark this box and include an attachment stating the date of the meeting of such members or stockholders at which the election to accept articles 121 to 137 of this title was made, a statement that a quorum was present at the meeting, and a statement that such acceptances was authorized by at least two-thirds of the votes that members or stockholders present at such meeting in person or by proxy were entitled to cast. OR If there are no members or stockholders entitled to vote thereon, mark this box and include an attachment stating such fact, the date of the meeting of the board of directors at which election to accept said articles was made, that a quorum was present at the meeting, and a statement that such acceptance was authorized by a majority vote of the directors in office. 4. The corporate entity followed the requirements of the law under which it was formed, its articles of incorporation, and its bylaws so far as applicable in effecting such acceptance. 5. Any attached copies of the articles of incorporation, affidavit, or other basic corporate charter of the corporate entity is true and correct. 6. If the corporate entity has issued stock, mark this box and include an attachment stating such fact including the number of shares heretofore authorized, the number issued and outstanding, and a statement that all issued and outstanding shares of stock have been delivered to the corporate entity to be cancelled upon the acceptance of articles 121-137 of title 7, C.R.S. by the corporate entity becoming effective and that from and after the effective date of said acceptance the authority of the corporate entity to issue shares of stock is terminated. This shall not apply to corporate entities formed for the acquisition and distribution of water to their stockholders. 7. (Optional) Delayed effective date: ______________________ (mm/dd/yyyy) Notice: ELEC_NP Page 1 of 2 Rev. 6/16/2005 American LegalNet, Inc. www.FormsWorkFlow.com Causing this document to be delivered to the secretary of state for filing shall constitute the affirmation or acknowledgment of each individual causing such delivery, under penalties of perjury, that the document is the individual's act and deed, or that the individual in good faith believes the document is the act and deed of the person on whose behalf the individual is causing the document to be delivered for filing, taken in conformity with the requirements of part 3 of article 90 of title 7, C.R.S., the constituent documents, and the organic statutes, and that the individual in good faith believes the facts stated in the document are true and the document complies with the requirements of that Part, the constituent documents, and the organic statutes. This perjury notice applies to each individual who causes this document to be delivered to the secretary of state, whether or not such individual is named in the document as one who has caused it to be delivered. 8. Name(s) and address(es) of the individual(s) causing the document to be delivered for filing: ____________________ ______________ ______________ _____ (Last) (First) (Middle) (Suffix) ______________________________________________________ (Street name and number or Post Office Box information) ______________________________________________________ __________________________ ____ (City) (Province ­ if applicable) (State) (Country ­ if not US) ____________________ (Postal/Zip Code) _______________________ ______________ (The document need not state the true name and address of more than one individual. However, if you wish to state the name and address of any additional individuals causing the document to be delivered for filing, mark this box name and address of such individuals.) and include an attachment stating the Disclaimer: This form, and any related instructions, are not intended to provide legal, business or tax advice, and are offered as a public service without representation or warranty. While this form is believed to satisfy minimum legal requirements as of its revision date, compliance with applicable law, as the same may be amended from time to time, remains the responsibility of the user of this form. Questions should be addressed to the user's attorney. ELEC_NP Page 2 of 2 Rev. 6/16/2005 American LegalNet, Inc. www.FormsWorkFlow.com Mail form with correct payment to: Colorado Secretary of State 1700 Broadway Ste 200 Denver, CO 80290 Make checks payable to: Colorado Secretary of State Include a separate check for each form submitted for filing. If a document is rejected, this will allow us to return the check at the time of rejection (if applicable). The document can be corrected and resubmitted with the returned check. Checks must be written for the exact amount or the document may be rejected and returned. Do not include this page with your filing. American LegalNet, Inc. www.FormsWorkFlow.com