State of Alaska Division of Corporations, Business and Professional Licensing CORPORATIONS SECTION PO Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Website: www.commerce.state.ak.us/occ DO NOT STAMP ABOVE THIS BOX CORP NOTICE OF CHANGE OF MEMBERS AND/OR MANAGERS Domestic or Foreign Limited Liability Company (OFFICE USE ONLY) Name of LLC__________________________________________________ Alaska Entity #____________ Prior Information: Please provide only the name & title of the prior member and/or manager being replaced. Name of prior member and/or manager being replaced Title If necessary use an 8½” x 11” sheet of paper and attach it to this form. ►The LLC must have at least one member. Please list the name, address and % held of each person/entity owning at least 5% interest in the company New Information: Please provide only the below information of the replacements for the above prior members and/or managers. Title Name of the replacement for Mailing Address City, State Zip (►Indicates above prior member/manager Required) % Held ► Member Manager Member Manager Member Manager Member Manager If necessary use an 8½” x 11” sheet of paper and attach it to this form. This notice must be signed by an authorized person. Signature of Authorized Person Title Date To resolve questions with this filing: Please be aware, this form will become public information. Contact Name Contact Phone Number There are no fees associated with this filing. If there is a change in the registered agent of this limited liability company, a Registered Agent Registered Address Statement of Change form is required. Forms and additional information are available on our web site at http://www.commerce.state.ak.us/occ Return this form to: 08-638 (Rev. 07/2010) State of Alaska Corporations Section PO Box 110806, Juneau, AK 99811-0806 American LegalNet, Inc. www.FormsWorkFlow.com