STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT FACING PAGE APPLICATION FOR APPROVAL TO ACQUIRE CONTROL, MERGE WITH, OR PURCHASE OR SELL DBO-CACL 280.250 (Rev. 10-17) (Department of Business Oversight Use Only) Department of Business Oversight Fee Paid $ File No. Receipt No. Acquisition of Control, Section 28500 Merger, Section 28601 Purchase of Business, Section 28601 Sale of Business, Section 28601 STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT FACING PAGE FOR APPLICATION FOR APPROVAL TO ACQUIRE CONTROL, MERGE WITH, OR PURCAHSE OR SELL ALL OR SUBSTANTIALLY ALL OF THE BUSINESS OF ANOTHER PERSON, OR TO SELL ALL OR ANOTHER LICENSEE. PRE-AUTHORIZATION AMENDMENT NO. The Application For Approval To Acquire Control, Merge With, Or Purchase Or Sell All Or Substantially All Of The Business Of Another Person, Or To Sell All Or Substantially All Of The MUST be TYPEWRITTEN and accompanied by the application fee of $900. The application (together with the fee payable to the Commissioner of Business Oversight) must be filed only in the Sacramento Office of the Department of Business Oversight. Special Instructions: An Application for Authorization for a Change of Control under the Capital Access Company Law shall include (1) this completed Facing Page, (2) the completed and revised applicable pages of the Application for a License Under the Capital Access Company Law (but not the Facing Page for that application) with information contained therein necessary to enable the Commissioner of Business Oversight to make findings required by Corporations Code Sections 28551 and 28604 and attached to this completed Facing Page, and (3) the duly executed and verified Execution Page for this application. (A blank Execution Page may be found at the end of the Application for a License.) In pursuance of, and in compliance with, the provisions of the Capital Access Company Law, the licensee, , with its principal office located at: (Number and Street Code) (City) (State) (Zip Code) hereby applies to the Commissioner of Business Oversight for authorization for a change of control. American LegalNet, Inc. www.FormsWorkFlow.com STATE OF CALIFORNIA DEPARTMENT OF BUSINESS OVERSIGHT FACING PAGE APPLICATION FOR APPROVAL TO ACQUIRE CONTROL, MERGE WITH, OR PURCHASE OR SELL DBO-CACL 280.250 (Rev. 10-17) Page 2 of 2 1. a. Date of Organization: b. State of Organization 2. Please provide the following information: a. For application for approval to acquire control of the licensee, describe in detail how applicant meets the criteria stated in Section 28551 of the Corporations Code. b. For applications for approval of a merger, purchase or sale of the licensee, describe in detail how applicant meets the criteria stated in Section 28604 of the Corporations Code. [The application continues on the following, separate pages.] (See Special Instructions, above.) American LegalNet, Inc. www.FormsWorkFlow.com