Statement of Abandonment of Plan of Interest Exchange: All Entity Types 08-0567 New 07/01/2014 Instructions Page 1 of 2 These instructions and the attached form 08-567 are specifically for STATEMENT OF ABANDONMENT OF PLAN OF INTEREST EXCHANGE Under the Alaska Entity Transactions Act AS 10.55.304 Filing Fee: $25.00 (non-refundable) INSTRUCTIONS FOR STATEMENT OF ABANDONMENT (Please retain for your records): WHAT IS AN INTEREST EXCHANGE? An Interest Exchange means a transaction authorized by AS 10.55.301-10.55.306. Under this: A domestic (Alaskan) acquiring (gaining) entity may acquire all of one or more classes or series of interests of another domestic (Alaskan) or foreign (non-Alaskan) acquired (releasing) entity; -OR- All of one or more classes or series of interests of a domestic (Alaskan) acquired (releasing entity) may be acquired by another domestic (Alaskan) or foreign (non-Alaskan) acquiring (gaining) entity; -OR- A foreign (non-Alaskan) entity may be the acquiring (gaining) entity or acquired (releasing) entity in an interest exchange under AS 10.55.301-306 if the interest exchange is authorized by the law of the foreign entity222s jurisdiction of organization. Except as otherwise provided in the acquiring (gaining) entity222s organic law or rules; the interest holders of the acquiring entity are not required to approve the interest exchange. NOTE: Pursuant to Alaska Statutes 10.55.304(c), after a plan of interest exchange has been approved by a domestic (Alaskan) acquired (releasing) entity and before a statement of interest exchange becomes effective, the plan of interest exchange may be abandoned by submitting the following Abandonment of Plan of Interest Exchange: ITEM 1: Provide the acquiring (releasing) entity name, the Alaska Entity Number (if applicable), the jurisdiction (home state), and the entity type of the acquired entity. NOTE: The name must match the name of the acquired entity in the plan of interest exchange or listed in Item #1 on the Statement of Interest Exchange. ITEM 2: A Statement of Abandonment can only be filed after a Statement of Interest Exchange has been filed with the department and before it becomes effective. (Note: The Statement of Interest Exchange effective date is the date filed with this division or a future effective date if provided in the Statement of Interest Exchange.) ITEM 3: This statement is required by statute. Please read through and verify. Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Email: corporations@alaska.gov Website: http://commerce.alaska.gov/cbpl/corp ALASKADepartment of Commerce, Community, and Economic DevelopmentDivision of Corporations, Business and Professional Licensing THESTATEof American LegalNet, Inc. www.FormsWorkFlow.com Statement of Abandonment of Plan of Interest Exchange: All Entity Types 08-0567 New 07/01/2014 Instructions Page 2 of 2 ITEM 4: The statement must be signed on behalf of the acquired (releasing) entity (listed in Item # 1 on the Statement of Abandonment of Interest Exchange) in the following manner: If the acquired entity is a corporation, it must be signed by an officer of the corporation. If the acquired entity is not a corporation, it must be signed by the person authorized by the entity. If the acquired entity is in the hands of a receiver, trustee, or other court-appointed fiduciary, it must be signed by the fiduciary. If the acquired (releasing) entity is a currently on record with this division (has an AK Entity Number) and the signer is an official of the entity then the signer must be currently on record with this division. Provide the printed name of the signer, the full title/capacity of the authorized signer, the name of the entity that the individual is representing, and signature of the individual authorized to sign. NOTE - Signatures: Per AS 10.55.609, persons who sign documents to be filed with the commissioner that are known by the person to be false in material respects are guilty of a class A misdemeanor. SUBMITTAL: Please submit forms and payment together. Mail the Statement of Abandonment of Plan of Interest Exchange (form 08-567) and the $25.00 non-refundable filing fee in U.S. dollars to: o State of Alaska, Corporations Section, PO Box 110806, Juneau, AK 99811-0806 If faxing the form please include the Credit Card Payment form with the appropriate fees. Do not email forms or payment. STANDARD PROCESSING TIME for complete and correct applications submitted to this office is approximately 10-15 business days. All applications are reviewed in the date order they are received. ADDITIONAL RESOURCES: Professional Licensing Section: For information regarding what professions require a professional license, statutes, how to obtain a professional license, and/or the expiration date if you already have a professional license, visit the Professional Licensing website at http://commerce.alaska.gov/cbpl/pl. NOTICE: if a professional license is owned by an entity and there is a change in the entity then the professional license may be impacted. Contact the appropriate professional licensing examiner. Business Licensing Section: For the privilege of engaging in a business in the State of Alaska, a business license is required for a new entity. For information regarding business licenses, statutes, and how to obtain a business license, visit the Business Licensing website at http://commerce.alaska.gov/cbpl/bl. NOTE: a change in the ownership of a business license requires a new business license. Alaska Corporate Net Income Tax: Every corporation earning gross income from sources within the state, except for those corporations that are specifically exempted, must file a corporation net income tax return. Contact the Alaska Department of Revenue, Tax Division, PO Box 110420, Juneau, Alaska, 99811-0420, telephone number (907) 465-2320 for more information. American LegalNet, Inc. www.FormsWorkFlow.com Statement of Abandonment of Plan of Interest Exchange: All Entity Types 08-0567 New 07/01/2014 Page 1 of 2 Specifically for STATEMENT OF ABANDONMENT OF PLAN OF INTEREST EXCHANGE All Entity Types Under the Alaska Entity Transactions Act AS 10.55.304(c) $25.00 Filing Fee (non-refundable) ($25 Corp Fee) Pursuant to Alaska Statutes 10.55.304(c), after a plan of interest exchange has been approved by a domestic (Alaskan) acquired (releasing) entity and before a statement of interest exchange becomes effective, the plan of interest exchange may be abandoned by submitting the following Abandonment of Plan of Interest Exchange: ITEM 1: Name of the acquired (releasing) entity: Alaska Entity # (if applicable): (This must match the name of the acquired entity in the plan of interest exchange or in Item # 1 on the Statement of Interest Exchange.) State of Domicile or Jurisdiction (home state): Type of Entity: Attach a separate 8.5224 x 11224 sheet with additional corporations, if necessary. ITEM 2: The date on which the plan of interest exchange or the Statement of Interest Exchange, with a future effective date, was filed for record with this division (mm/dd/yyyy format): // ITEM 3: The interest exchange has been abandoned in accordance with AS 10.55.304. COR Corporations Section State Office Building, 333 Willoughby Avenue, 9th Floor PO Box 110806, Juneau, AK 99811-0806 Phone: (907) 465-2550 Fax: (907) 465-2974 Email: corporations@alaska.gov Website: http://commerce.alaska.gov/cbpl/corp THE STATE ALASK A ofDepartment of Commerce, Community, and Economic DevelopmentDivision of Corporations, Business and Professional Licensing American LegalNet, Inc. www.FormsWorkFlow.com Statement of Abandonment of Plan of Interest Exchange: All Entity Types 08-0567 New 07/01/2014 Page 2 of 2 ITEM 4: The Abandonment of the Plan of Interest Exchange must be signed by the acquired (releasing) entity (listed in Item # 1 above). If the acquired entity is a corporation, it must be signed by an officer of the corporation. If the acquired entity is not a corporation, it must be signed by the person authorized by the entity. If the acquired entity is in the hands of a r