_________________________________________________________________________________________________________ DO NOT WRITE ABOVE THIS LINE, FOR ACC USE ONLY EXTENSION REQUEST LETTER Pursuant to A.R.S. §§10-1622.(C) & 10-11622.(C). Requested by: Name: _____________________________________________________ Address: _____________________________________________________ _____________________________________________________ RE: Corporation Name: ________________________________________________ File Number:________________ Annual Report Due Date:__________________ Enclosed find check #____________ in the amount of $________________ to pay the annual registration fee for the above referenced corporation. THE ABOVE REFERENCED CORPORATION WILL BE UNABLE TO FILE THE ANNUAL REPORT ON OR BEFORE THE SPECIFIED DUE DATE. ON BEHALF OF THE CORPORATION, I WOULD LIKE TO REQUEST A 6 MONTH EXTENSION TO FILE THE ANNUAL REPORT. Date: _________________________ Signature:_________________________________________________ Printed Name: __________________________________________ Title: _____________________________________ * * * * * * * * * * FOR OFFICE USE ONLY * * * * * * * * * * A SIX-MONTH EXTENSION IS HEREBY GRANTED TO THE ABOVE-NAMED CORPORATION PURSUANT TO A.R.S. §§ 10-1622.(C) or 10-11622.(C). A BUSINESS CORPORATION’S FAILURE TO FILE THE ANNUAL REPORT BY THIS DATE WILL RESULT IN A PENALTY OF 20% PER MONTH CALCULATED FROM THE ORIGINAL DUE DATE. NEW DUE DATE: ___________________________ AR:0038 Rev 09/2008 Arizona Corporation Commission Corporations Division American LegalNet, Inc. www.FormsWorkflow.com