Statement of Conversion-Any Domestic Entity Converting to a Foreign or Domestic Non-Qualified Entity 08-0588 New 07/01/2014 Page 1 of 3 STATEMENT OF CONVERSION Specifically for A Domestic (Alaskan) Entity Converting to a Non-qualified (not on record with this division) Foreign (non-Alaskan) or Domestic (Alaskan) Entity which will NOT be Conducting Business in Alaska Under the Alaska Entity Transaction Act AS 10.55.401-10.55.406 $25.00 Filing Fee (non-refundable) INSTRUCTIONS FOR STATEMENT OF CONVERSION (Please retain for your records): IMPORTANT: This form is to be used only if the converted entity (listed in Item # 1 on the Statement of Conversion) will not be conducting business in Alaska. NOTICE: The Statement of Conversion will not be filed if a biennial report is due. Please verify the following for the converting entity before completing the application: Is the qualified entity (on record with this division) in 223Good Standing224 status? Have all required biennial reports been filed? Are the officials on record correct, current and up to date? (Used to verify signatures for this filing.) Is the Registered Agent information on record correct, current and up to date? To verify the above information you may search for the entity by going to the above website, click License Search and under Search License Data select Corporations. If there is a biennial report due, it may be filed online (for immediate posting) by selecting Biennial Reports on the above website. If the officials have changed and there is no biennial report due then please submit a Notice of Change of Officials located on the above website under Forms and Fees. Select the appropriate version based on your entity type. If the Registered Agent information needs to be updated please submit a Statement of Change located on the above website under Forms and Fees. Select the appropriate version based on your entity type. WHAT IS A CONVERSION? Conversion (when an entity changes/transforms from one type of entity into a different type of entity) means a transaction authorized by AS 10.55.401-10.55.406, with the exception of the entities excluded under AS 10.55.110. Under this: Any domestic (Alaskan) entity may convert to a foreign (non-Alaskan) entity that is not qualified to do business in Alaska if the conversion is authorized by the law of the foreign jurisdiction. 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 Conversion-Any Domestic Entity Converting to a Foreign or Domestic Non-Qualified Entity 08-0588 New 07/01/2014 Page 2 of 3 NOTE: The converting (changing from) domestic (Alaskan) entity filing this form will not be qualified (on record with this division) and will not be conducting business in Alaska. ITEM 1: Provide the converting (changing from) entity name, the Alaska Entity Number (mandatory) and the entity type of the converting entity. ITEM 2: Provide the converted (changing to) entity name, the domicile or jurisdiction (home state), and the entity type of the converted entity. ITEM 3: (Optional) The future effective date of conversion, if different from date of filing, must be a specific future date and cannot exceed 90 days from date of filing. Future effective date (mm/dd/yyyy format). ITEM 4: This statement is required by statute. Please read through and verify. ITEM 5: The converted (changing to) unqualified (not on record with this division) entity (listed in Item #2 above), which is not conducting business in Alaska, provides address to which the department may send any process served on the commissioner under AS 10.55.406(e). ITEM 6: The Statement of Conversion must be signed on behalf of the converting (changing from) entity (listed in Item #1 above) in the following manner: If the converting entity is a corporation, it must be signed by an officer of the corporation. If the converting entity is not a corporation, it must be signed by the person authorized by said entity. If the converting entity is in the hands of a receiver, trustee, or other court-appointed fiduciary, it must be signed by said fiduciary. If the converting entity is 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. NOTE - Plan of Conversion -OR- Statement of Conversion: Do not send both together. Submit either the Statement of Conversion OR the plan of conversion that is signed on behalf of all entities and contains all the information required to be in the Statement of Conversion and is delivered to the Division for filing after the plan has been adopted and approved by all entities. Sending both the plan of conversion and the Statement of Conversion together may cause delays in processing time. SUBMITTAL: Please submit forms and payment together. Mail the Statement of Conversion (form 08-588) 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. American LegalNet, Inc. www.FormsWorkFlow.com Statement of Conversion-Any Domestic Entity Converting to a Foreign or Domestic Non-Qualified Entity 08-0588 New 07/01/2014 Page 3 of 3 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 Conversion: Any Domestic Entity Converting to a Foreign or Domestic Non-Qualified Entity 08-0588 New 07/01/2014 Page 1 of 2 STATEMENT OF CONVERSION Specifically for A Domestic (Alaskan) Entity Converting to a Non-qualified (not on record with this division) Foreign (non-Alaskan) or Domestic (Alaskan) Entity which will NOT be Conducting Business in Alaska Under the Alaska Entity Transaction Act AS 10.55.401-10.55.406 $25.00 filing fee (non-refundable) ($25 Corp Fee)IMPORTANT: Use this form only if converted (changing to) foreign (non-Alaskan) or domestic (Alask