Arkansas Secre t a ry of State Charlie Daniels State Capitol • Little Rock, Arkansas 72201-1094 501-682-3409 • www.sos.arkansas.gov APPLICATION FOR REGISTRATION OF CORPORATE NAME INSTRUCTIONS: Mail to the Secretary of State’s Business Services Division, State Capitol, Little Rock, Arkansas 72201-1094. A file stamped copy will be returned to the above address for your files. A foreign corporation may renew this registration for successive years by filing a renewal application between October 1 and December 31 of the preceding year. The renewal application when filed renews the registration for the following calendar year. New Renewal Pursuant to the Arkansas Business Corporation Act (Act 958 of 1987), the undersigned corporation hereby applies for the registration of the corporate name and submits the following: 1 a. The name of the corporation is: 1 b.* The fictitious name if the name of the corporation is unavailable in the state of Arkansas is 2. It is incorporated under the laws of 3. The date of its incorporation is 4. The business in which it is engaged is 5. The foreign corporation shall deliver with the completed application a certificate of existence (or document of similar import) duly authorized by the Secretary of State or other official having custody of corporate records in the state or country under whose laws it is incorporated. 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. Authorizing Officer and Title (Type or Print) Authorized Signature * If this registration is on a fictitious name, reference item (1b), this application must be accompanied by a copy of the resolution of the corporation's board of directors, certified by its secretary, adopting the fictitious name. Fee: $50.00 Renewal: $25.00 F-05 Rev. 4/06 American LegalNet, Inc. www.FormsWorkflow.com