CERTIFICATE OF REINSTATEMENT STOCK OR NON-STOCK CORPORATION Office of the Secretary of the State MAILING ADDRESS: Commercial Recording Division Connecticut Secretary of the State P.O. Box 150470 Hartford, CT 06115-0470 860-509-6003 Space For Office Use Only DELIVERY ADDRESS: Commercial Recording Division Connecticut Secretary of the State 30 Trinity Street Hartford, CT 06106 860-509-6003 Filing Fee: $150.00 Stock $80.00 Nonstock Make Checks Payable To “Secretary of the State” Please contact the Department of Revenue Services or your tax advisor as to any potential tax liability relating to your business. 1. NAME OF CORPORATION: 2. PLACE A CHECK MARK NEXT TO A. OR B.: _____A. The corporation is a Connecticut Stock Corporation. _____B. The corporation is a Connecticut Non-stock Corporation. 3. APPOINTMENT OF REGISTERED AGENT: (Please select one A. or B.) A. Individual’s Name: Business address: Residence address: B. Business Entity: Address: Acceptance of appointment _____________________________________________________________ Signature of agent 4. EXECUTION: Dated this _________________day of ____________________, 20_____. Print or type name of signatory Capacity of signatory Signature REV. 08/23/2007 American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS FOR COMPLETION OF THE CERTIFICATE OF REINSTATEMENT CONNECTICUT STOCK OR NON-STOCK CORPORATIONS Instructions 1. NAME OF CORPORATION: Please provide the complete name of the corporation, as it appeared on the records of the Secretary of the State at the time it was administratively dissolved, i.e., dissolved by the Secretary of the State. If the name is no longer available, please complete and file a Certificate of Amendment along with the Certificate of Reinstatement changing the name of corporation to a name, which is available. 2. PLACE A CHECK MARK NEXT TO A. OR B.: Indicate the type of corporation, stock or non-stock, which is filing the certificate. This information must be consistent with the corporation's records in the Office of the Secretary of the State. 3. APPOINTMENT OF REGISTERED AGENT: The corporation must appoint a registered agent. It may not appoint itself as its registered agent. The registered agent may be either a natural person who is a resident of Connecticut, a Connecticut corporation; limited liability company; registered limited liability partnership or statutory trust or foreign authorized/registered corporation; limited liability company; registered limited liability partnership or statutory trust. Please note the following: if the agent being appointed is a natural person, that person's business address must be provided under the heading Business address and their residence address under the heading Residence address; if the agent appointed is a corporation, it must provide its principal office address under the Business office address heading; the agent must sign accepting the appointment in the space provided; the signatory must state the capacity under which they sign if signing on behalf of a corporation; and all addresses must include a street number, street name, city, state and postal code. Complete street addresses required. P.O. Boxes are only acceptable as additional address information. 4. EXECUTION: The document must be executed by an authorized official of the corporation. That person must print or type their name, state the capacity under which they sign and provide a signature. The execution constitutes a legal statement under the penalties of false statement that the information provided in the document is true. GENERAL INFORMATION: The Certificate of Reinstatement must be filed with a current annual report and up to date clearance letters from the Department of Revenue Services and the Department of Labor. Please contact the Department of Revenue Services or your tax advisor as to any potential tax liability relating to your business. REV. 08/23/2007 American LegalNet, Inc. www.FormsWorkflow.com SECRETARY OF THE STATE 30 TRINITY STREET POST OFFICE BOX 150470 HARTFORD, CT 06115-0470 REINSTATEMENT OF A CONNECTICUT CORPORATION Filing Fee: $150 reinstatement & annual report fees (stock) $ 80 reinstatement & annual report fees (non-stock) Please make check(s) or money order(s) payable to the Secretary of the State A Connecticut corporation which has been administratively dissolved may be reinstated by filing a Certificate of Reinstatement in this office. Administratively dissolved means that the corporation was dissolved by the Secretary of the State. The reinstatement procedure is not available to corporations, which have been voluntarily dissolved by resolution. Before filing the forms described below you may wish to reserve the name of the corporation in order to ensure its availability at the time of filing.* The Certificate of Reinstatement must be accompanied by the following documents: 1. A current annual report (enclosed please find separate instruction sheet to assist in the completion of the report). If corporation not previously organized, must file organization and first report instead of the annual report. - AND 2. Up-to-date statements from the State Tax Commissioner (Revenue Services) and the Administrator of Unemployment Compensation (Labor Department). These statements should be obtained by mailing written requests to the each of the respective agencies at the following locations: Department of Revenue Services Audit Division Corporation Tax Office Unit 25 Sigourney Street Hartford CT 06106 Employer Status Department Connecticut State Labor Department Employment Security Division 200 Folly Brook Boulevard Wethersfield CT 06109 In each request, please indicate that the statements are to be used as part of a Certificate of Reinstatement. ALL REQUIRED DOCUMENTS MUST BE SUBMITTED TOGETHER * The fee to reserve a corporate name for 120 days is $30.00. If the corporation's name is not available at the time a reinstatement is filed, the corporation must simultaneously change its name by filing a Certificate of Amendment. The fee for filing the Certificate of Amendment is $50.00 for a stock corporation and $10.00 for a non-stock corporation. Rev. 08/23/2007 American LegalNet, Inc. www.FormsWorkflow.com