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 OFFICERS OR DIRECTORS Domestic or Foreign Non Profit Corporations Name of Non-Profit Corporation (OFFICE USE ONLY) ________________________________ Alaska Entity #____________ Prior Information: Please provide only the name & title of the prior officer/director being replaced. Name of prior officer/director being replaced Title If necessary use an 8½” x 11” sheet of paper and attach it to this form. ►All non-profit corporations must have at least three directors, a president, vice president, secretary and treasurer. The president and secretary cannot be the same person. New Information: Please provide only the name, address & title of the replacements for the above prior officers/directors. Name of the replacement Title for above prior Mailing Address City, State Zip (►Indicates Required) officer/director ►President X if Director ►Vice President ►Secretary ►Treasurer ►Director ►Director ►Director If necessary use an 8½” x 11” sheet of paper and attach it to this form. This notice must be signed by the president or vice-president. 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 corporation, a Registered Agent Registered Address Statement of Change form is required. This, other forms and additional information are available on our web site at http://www.commerce.state.ak.us/occ Return this form to: 08-637 (Rev. 06/29/10) State of Alaska Corporations Section PO Box 110806, Juneau, AK 99811-0806 American LegalNet, Inc. www.FormsWorkFlow.com