SECRETARY OF THE STATE OF CONNECTICUT MAILING ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, P.O. BOX 150470, HARTFORD, CT 06115-0470 DELIVERY ADDRESS: COMMERCIAL RECORDING DIVISION, CONNECTICUT SECRETARY OF THE STATE, 30 TRINITY STREET, HARTFORD, CT 06106 PHONE: 860-509-6003 WEBSITE: www.concord-sots.ct.gov FAX FILING SERVICE REQUEST FAX BUSINESS FILINGS TO: (860) 509-6069 UCC/COPIES/LEGAL EXISTENCES TO: (860) 509-6057 USE INK. COMPLETE ALL SECTIONS. PRINT OR TYPE. ATTACH 81/2 X 11 SHEETS IF NECESSARY. FILING PARTY (CONFIRMATION WILL BE SENT TO THIS ADDRESS): OFFICE USE ONLY NAME: AMT. REC’D $ CA CR TRANS. ID: ADDRESS: BATCH DATE: CITY: STATE: ZIP: EXP/REF RETURN TO: TELEPHONE: 1. TYPE OF SERVICE REQUEST BUSINESS FILING UCC FILING (CANNOT BE EXPEDITED) COPY CERTIFICATE REQUEST 2. BUSINESS NAME / UCC NAME 3. SELECT EXPEDITED or ROUTINE SERVICE EXPEDITED SERVICE ROUTINE SERVICE ADDITIONAL $50.00 MUST BE INCLUDED FOR EACH EXPEDITED ITEM REQUESTED. ADD THIS AMOUNT TO EACH SERVICE/FILING FEE. COMPLETED WITHIN 3 TO 5 BUSINESS DAYS MAILED WHEN COMPLETED COMPLETED WITHIN 24 HOURS OF RECEIPT PICK-UP IS NOT AVAILABLE MAILED NEXT BUSINESS DAY AT 4:00PM IF NOT PICKED UP 4. REQUEST FOR COP(IES): CERTIFIED COPY ROUTINE ($55.00) PLAIN COPY EXPEDITED ($105.00) ROUTINE ($40.00) EXPEDITED ($90.00) TYPE OF DOCUMENT BEING REQUESTED: 5. REQUEST FOR CERTIFICATE(S) OF LEGAL EXISTENCE: CERTIFICATE OF LEGAL EXISTENCE (FEES FOR LIMITED LIABILITY COMPANIES / LP’S) CERTIFICATE OF LEGAL EXISTENCE (FEES FOR CORPORATIONS / LLP’S / STATUTORY TRUSTS) EXPRESS $40.00 (LLP'S & STATUTORY TRUSTS ONLY) EXPRESS $50.00 EXPRESS $50.00 (CORPORATIONS ONLY) SHORT $50.00 (REFLECTS ALL NAME CHANGES) SHORT $80.00 (REFLECTS ALL NAME CHANGES) LONG $100.00 (CANNOT BE EXPEDITED) LONG $120.00 (CANNOT BE EXPEDITED) 6. METHOD OF PAYMENT: BY INDICATING A CUSTOMER ID OR CREDIT CARD NUMBER, YOU ARE HEREBY AUTHORIZING DEBIT OF THE ACCOUNT/ CHARGE OF CREDIT CARD. TOTAL CHARGE: NOTE: EXPEDITED SERVICE REQUIRES AN ADDITIONAL FEE. IF THE FEE(S) ARE NOT INCLUDED, THE REQUEST(S) WILL BE COMPLETED ON A ROUTINE BASIS. PAYMENT BY AN ESTABLISHED CUSTOMER ACCOUNT. PAYMENT BY CREDIT CARD: CUSTOMER ID#: VISA (ONLY VISA OR MASTERCARD ACCEPTED) MASTERCARD NAME ON CREDIT CARD: 16 DIGIT CREDIT CARD #: EXPIRATION DATE (MONTH/YEAR): SECURITY CODE (LAST 3 DIGITS ON BACK OF CARD): ZIP CODE (MUST MATCH THIS CREDIT CARD BILLING ADDRESS): PAGE 1 OF 1 FORM FFSR-1-1.0 Rev. 10/22/2010 American LegalNet, Inc. www.FormsWorkFlow.com GUIDELINES FOR FAX FILINGS FAX REQUEST TO Document Review (860) 509-6069 UCC and Certification Unit (860) 509-6057 Please Note: Sending fax to the wrong number may result in a delay in processing your document. 1. Filing Requirements: Filer may use a prepaid account, which is in good standing, with the office. If you do not have an account with our office, check with our Financial Unit at (860) 509-6154. All filings must be received with our Fax Filing Service Request cover sheet. The Fax Filing cover sheet must be filled out completely for your document to be processed. Each filing must have its own separate Fax Filing Service Request cover sheet. Each filing will be considered received in its entirety. No “additional” or “correction” pages will be accepted after submission. Filings that are not legible will be rejected. Official filing hours are Monday - Friday, 8:30 a.m. - 4:00 p.m., except state holidays. Any filing received on a holiday, weekend, or after the close of the filing day will be considered received as of the start of the next business day. There will be no additional costs for fax filing requests. If EXPEDITED SERVICE is requested, an additional $50.00 per transaction is required. Please Note: EXPEDITED SERVICE is not available for Uniform Commercial Code (U.C.C.) filings. 2. Acceptable Faxed Filings for Document Review: Title 33 and Chapter 613 of Title 34 of the Connecticut General Statutes provides the statutory authority for the transmittal of faxed filings. All filings related to the following will be accepted: o o o o o o Domestic Stock Corporations Domestic Nonstock Corporations Foreign Stock Corporations Foreign Nonstock Corporations Domestic Limited Liability Companies Foreign Limited Liability Companies 3. Acceptable Faxed Filings for Uniform Commercial Code (U.C.C.) Title 42a of the Connecticut General Statutes provides the statutory authority for the transmittal of faxed filings. All filings related to the following will be accepted: o o o o Initial Financing Statement Amendment Correction Statement Search Requests 4. Certification Unit Request: These filings are available for all entities: o Certified Copies o Plain Copies o Certificates of legal existence 5. Document Review Unit and Certification Unit Confirmation Procedure All confirmation letters, whether acceptance or rejection of a Business or UCC filing, will be mailed to the filer. Certified copies and legal existences will also be mailed or placed in the filer's pick up box. (Revised 10/22/2010) American LegalNet, Inc. www.FormsWorkFlow.com