Mail all forms and required payment to: Department of Consumer and Regulatory Affairs Corporations Division PO Box 92300 Washington, DC 20090 Phone: (202) 442 - 44 32 Corporate Online Services Information: Many corporate filings are available by using CorpOnline Service. Go to CorpOnline site at https://corp online .dcra.dc.gov , create the profile, access the online services main page and proceed. Online filers must pay by using the credit card. District of Columbia Government Corporations Division Withdrawal of Foreign Registration Statement Form F N - 3 , Ver. 2 , April 2018 . Use this form to withdraw foreign filing entity from the District of Columbia. This withdrawal has no effect on entity s licensing and/or tax obligations so It is organization s responsibility to ensure compliance in those areas. ENTITY TYPE / AUTHORITY FILING F E E Foreign Filing Entity : 247 29 105.07. Refer to Corporate Fee Schedule posted online; Under the provisions of the Title 29 of D.C. Code (Business Organizations Act), the foreign filing entity listed below hereby applies for a Certificate of Withdrawal and for that purpose submits the statement below. 1.Entity Name. 2 . Date of Issuance of Certificate of Foreign Registration. 3.Name of State /Province/ Country of Formation. 4. The entity is not doing business in the District and that it withdraws its registration to do business in the District. 4A. T he entity revokes the authority of its registered agent to accept service on its behalf . 4B. Address for the service of process. (Address that legal complaints can be forwarded to). If you sign this form you agree that anyone who makes a false statement can be punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC 247 22 - 2405; 5 . Name of the Governor or Authorized Person: 5A . Si gnature of the Governor or Authorized Person . American LegalNet, Inc. www.FormsWorkFlow.com