Instructions for properly completing a Filing Memo Mark the appropriate priority box. (Additional Expedited Cost) Fees: Priority 1 (One hr) Priority 2 (Two hr) Priority 3 (Same Day) Priority 4 (24 hour) $1000.00 $ 500.00 Varies ­ Please contact our Office Varies ­ Please contact our Office Submitters Information 1. 2. Completely fill out your individual or business/firm name and complete address. The attention line needs to be completed if a business or firm name is listed. The account number is only to be completed by entities that have an existing Depository account with the Division of Corporations. Please ignore this field if you do not have a Depository account. Filing Information Complete the name of the entity and the entity file number. If you do not have the file number, you may leave it blank. Method of Return All documents are returned Regular Mail or you can provide a Fed-X or UPS account number for express mail. Please mark the appropriate method of return. Credit Card Information All credit card information must be completed. If the credit card information is not the same as it is listed with the submitter's information, then please specify the correct information in the comments/filings instruction area on the bottom right hand side of the memo. You must also include your 3-4 digit security code on the back of the card. Please contact our office at 302-739-3073 with any questions or for verification of fees. Return forms and memos to: Delaware Division of Corporations 401 Federal Street - Suite 4 Dover, DE 19901 American LegalNet, Inc. www.FormsWorkFlow.com State of Delaware - Division of Corporations DOCUMENT FILING SHEET - Fax# 302/739-3812 Priority 1 (One hr) Priority 2 (Two Hr.) Priority 3 (Same Day) Priority 4 (24 Hour) Priority 7 (Reg. Work) SUBMITTER'S INFORMATION Company/Firm or Individual's Name Return Address City ­ State - Zip Attention: Phone# E-mail address Account Number Fax# DO NOT WRITE IN THIS SPACE EACH REQUEST MUST BE SUBMITTED AS A SEPARATE ITEM WITH THIS FILING SHEET AS THE FIRST PAGE OF EACH SUBMISSION. DOCUMENT FILING REQUEST INFORMATION Name of Company/Entity File Number Type of Document Check if document is: Changing Name Changing Registered Agent Changing Stock METHOD OF RETURN _____ Messenger/Pick up _____ Express Service Delivery Select Express Type Acct#___________________________________ _____ Regular Mail _____ Reservation Number OTHER DOCUMENT FILING INFORMATION # of Certified Copies returned Other requests Check # Total $ enclosed Fax or e-mail is not available. Other __________________________________ (Visa, MasterCard, American Express & Discover Card Only) CREDIT CARD INFORMATION Card Type / Sec. Code_________ COMMENTS/FILING INSTRUCTIONS Expiration Date - INSTRUCTIONS 1. 2. Visit corp.delaware.gov/cvrmemo.shtml for complete instructions on how to properly complete this memo. Fully shade in the required Priority Square using a dark pencil or marker, staying within the square. . Delaware Division of Corporations, 401 Federal Street, Ste. 4, Dover, De 19901 American LegalNet, Inc. www.FormsWorkFlow.com