Special Filings Order Form To obtain information relating to a filing of record with the Secretary of State, complete the information below along with the order form on the following page, attach a check (made payable to the Secretary of State) for the appropriate amount (or “not to exceed” a specified amount written below the amount payable line) and submit your request: • By mail, along with a self-addressed stamped envelope, to Secretary of State, Special Filings Unit, 1500 11th Street, 3rd Floor, Sacramento, CA 95814. • In person, to the Secretary of State’s office in Sacramento. A special handling fee of $6.00 per filing is applicable for any of the following information requested over the counter NAME AND FILE NUMBER (if applicable) YOUR NAME: NAME OF BUSINESS: (if applicable) MAILING ADDRESS: CITY: STATE: TELEPHONE NUMBER: ZIP: FAX NUMBER: 2002 © American LegalNet, Inc. NAME AND FILE NUMBER (if applicable) FILINGS, AMENDMENTS AND/OR ATTACHMENTS Copies of: Athlete Agent Athlete Agent Amendment Auctioneer/Auction Company Bond Credit Services Organization Dance Studio Discount Buying Organizations Employment Agencies Employment Counseling Immigration Consultant Bond Invention Developer Job Listing Nurses Registry Notice of Joint Powers Agreement Amendment to Notice of Joint Powers Agreement Statement of Facts Roster of Public Agencies Declaration of Domestic Partnership Termination of Domestic Partnership Certified copies ($5.00 per filing, in addition to the copying fees) copies @ $1.00 for the first page, and $0.50 for each additional page* @ $5.00 each *When ordering copies you may send a check for the appropriate amount, or if the number of pages is unknown when ordering copies, you may send a blank check “not to exceed” a specified amount written below the amount payable line. CERTIFICATES Certificate of Filing Certificate of Nonfiling @ $5.00 each name requested SPECIAL HANDLING – IN PERSON DELIVERY ONLY Certificates and copies of records @ $6.00 per record 2002 © American LegalNet, Inc.