APPLICATION FOR RENEWAL OF REGISTERED NAME BY FOREIGN CORPORATION Pursuant to A.R.S. §§ 10-403 & 10-3403 1. The name of the Corporation is ______________________________________. 2. If the exact name of the corporation is not available for use in this state, then the corporations may include additional words to make its name distinguishable. If applicable the name is:___________________________________________. 3. The Corporation originally registered the name __________________________ ________________________with the Arizona Corporation Commission on the _____day of ________________, ______ pursuant to A.R.S. §10-403 or § 10-3403 and has renewed that registration each year since. 4. The corporation was incorporated in the (circle one) State, Province or Country of _________________________ on the _____ day of _____________, _______. 5. The Corporation is engaged in the following business or nature of activities: ________________________________________________________________ 6. Attached hereto is a certificate of existence (good standing) or a similar document from the state, province or country of incorporation, dated within sixty days of delivery of this application to the commission. 7. In accordance with Arizona Revised Statutes §§10-403 & 10-3403, the Corporation hereby applies for renewal of the registration of its corporate name with any addition set forth above for the following year. 8. This application is accompanied by the renewal fee of $10.00 (U.S.) made payable to the Arizona Corporation Commission. Dated this ________ day of ____________________, ________. Signed: _______________________Title: _____________ Printed Name: ___________________________________ Mailing address:__________________________________ _______________________________________________ Phone: ________________ [optional] FAX: ______________ [optional] Deliver or mail with a check made payable to: ARIZONA CORPORATION COMMISSION 1300 West Washington OR 400 West Congress, Suite 221 Phoenix, Arizona 85007-2929 Tucson, Arizona 85701-1347 CF: 0037 Business Corporation Rev: 01/2007 Arizona Corporation Commission Corporations Division American LegalNet, Inc. www.FormsWorkflow.com