Version 1; 04-06-09 District of Columbia Government Corporations Division PO Box 92300 Washington DC 20090 Application for Certificate of Reinstatement for Foreign Limited Liability Company Use this form to reinstate a foreign limited liability company (LLC) in the District of Columbia. ENTITY TYPE Foreign Limited Liability Company FILING FEE $150, payable to DC Treasurer Under the provisions of the Limited Liability Company Act, DC Official Code Title 29 Chapter 10, the limited liability company below applies for a Certificate of Reinstatement of a proclaimed foreign limited liability company, and certifies as follows: 1. Entity Name at the time of proclamation: 2. New name that the company will be known as from now on. (If the LLC name is available, you must use that name; if the name has been taken by another company, then you may choose a different name.) 3. The Certificate of Registration to transact business in the District of Columbia was revoked on November 20 for failure and/or refusal to file reports for the reporting period or other reasons under DC Official Code (DCOC). (Revocation dates are always the 2nd Monday of November of the revocation year) 4a. Registered Agent in the District of Columbia at the time of proclamation 4b. That Registered Agent's address 5. Attach any DCOC-required delinquent reports and filing fees and penalties. 7. Signature 6. Check Company Representative executing this form Manager Member Authorized Person If you sign this application, you agree that you understand that anyone who makes a false statement anywhere on it can be punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC § 22-2405. Mail all forms and required payments to: Department of Consumer and Regulatory Affairs Corporations Division P.O. Box 92300 Washington, DC 20090 Phone: (202) 442-4400 For overnight delivery send to: Corporate Bank of America Attention: DC Government Wholesale Lockbox #92300 Mail Code MD4-301-18-04 225 North Calvert Street – 18th floor Baltimore, Maryland 21202 Please check dcra.dc.gov to view organizations required to register, to search business names, to get step-by-step guidelines to register an organization, to search registered organizations, and to download forms and documents. Just click on "Corporate Registrations." American LegalNet, Inc. www.FormsWorkFlow.com