District of Columbia Government Corporations Division PO Box 92300 Washington DC 20090 BRA-25 BUSINESS. Form Version 3, 12-31-09. Two-Year Report for Foreign & Domestic Business & Professional Corporation. Year of Filing: Use this form to file a two-year report for a domestic or foreign for-profit corporation. File Number: Date of Filing: Filing Fee: 2. Organized under the laws of which state or country. 1. Entity Name. 3. If this is a foreign corporation, address of principal office in state or country where it is organized. 4. Name of Registered Agent and address of registered office in DC 5. Brief statement of business affairs conducted in DC. 6. If this is domestic corporation, address of principal office in DC. 7. List all corporation directors and officers (attach list if needed) TITLE NAME DOMESTIC FOR-PROFIT CORPORATIONS: ANSWER 8-9 ADDRESS NO. OF SHARES CLASS SERIES PAR VALUE PER SHARE 8. Aggregate number of shares corporation has authority to issue 9. Aggregate number of shares issued 10. Date Organized FOREIGN FOR-PROFIT CORPORATIONS: ANSWER 12-14 12. Is corporation in good standing in state / country where it 11. Term of existence authorized is organized? Yes No PROFESSIONAL CORPORATIONS ONLY; Domestic Professional Corporations - Answer 13 and 14A; Foreign Professional Corporation - Answer 14B. 13. Attach the names and addresses, including street and number of all shareholders for Domestic Professional Corporation. 14A. Attach a statement signed by an officer of Domestic Professional Corporation that each shareholder, director and officer of the corporation is currently licensed to render a professional service for which the corporation is organized. 14B. Attach a letter on company's letterhead that lists the corporate employees that perform professional services in the District of Columbia and their license information. 15. Select corporate officer executing this form: President / Vice-President 16. Signature Secretary / Assistant Secretary Treasurer / Assistant Treasurer If you sign anywhere on the Two-Year Report Form, 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 payment to: Department of Consumer and Regulatory Affairs Corporations Division PO Box 92300 Washington, DC 20090 Phone: (202) 442-4400 American LegalNet, Inc. www.FormsWorkFlow.com