FICTITIOUS NAME REPORT TO: OKLAHOMA SECRETARY OF STATE 421 N.W. 13th, Suite 210 2300 N. Lincoln Blvd., Room 101, State Capitol Oklahoma City, Oklahoma 73103 73105-4897 (405) 522-2520 PLEASE NOTE: ONLY use this form when the legal name of a foreign corporation is prohibited by Title 18, Section 1140 of the Oklahoma Statutes. This form is not used to file a trade name or d/b/a in the state of Oklahoma. ATTACHED HERETO is the Certificate of Qualification for a foreign corporation. I, the authorized representative of: , a corporation duly organized under the laws of the State or Country of: , do hereby certify that the following is a true and correct copy of a resolution of the Board of Directors of said corporation: "It is RESOLVED, that said corporation, desiring to transact business in the State of Oklahoma, inasmuch the Board of Directors have been advised that the name of said corporation is not available for corporate use in the State of Oklahoma, adopts the following fictitious name: , which shall be used to the exclusion of its true name when transacting business in the State of Oklahoma pursuant to the provisions of Title 18, Section 1141 of the Oklahoma Statutes." The fictitious name report must be signed by a representative or representatives of the business entity duly authorized to sign on its behalf. Signature: Printed Name: Dated: Title: (SOS FORM 0032-08/12) American LegalNet, Inc. www.FormsWorkFlow.com