Arkansas Secre t a ry of State Charlie Daniels State Capitol • Little Rock, Arkansas 72201-1094 501-682-3409 • www.sos.arkansas.gov Business & Commercial Services, 250 Victory Building, 1401 W. Capitol, Little Rock Certificate of Transfer of Jurisdiction from Arkansas The undersigned, pursuant to Act 454 of 2001, sets forth the following: 1. Corporate name: 2. Date of incorporation: 3. The attached resolution was authorized on required number of shareholders. , by the 4. This corporation must provide evidence from the new state of jurisdiction that the transfer requested will be accepted in that state. 5. This corporation will be placed in PENDING status until the following requirement has been satisfied. Upon filing with the new state of jurisdiction, a certified copy of the Certificate of Incorporation or other official certificate evidencing the corporation's Incorporation under the laws of the new state of jurisdiction must be filed with the Arkansas Secretary of State's office. If this information is not received within 30 days of this filing date, this corporation will remain an Arkansas corporation in active status and may be subject to additional tax requirements. Executed this day of , . I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State is a Class C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days. (President or Vice President) (Secretary) ATTESTED BY: (President or Vice President) Filing fee $50.00 payable to Arkansas Secretary of State Rev. 4/06 American LegalNet, Inc. www.FormsWorkFlow.com