District of Columbia Government Corporations Division PO Box 92300 Washington DC 20090 BRA-25 LLC. Form Version 3, 12-31-09. Two-Year Report for Foreign & Domestic Limited Liability Company. Year of Filing: Use this form to file a two-year report for a domestic or foreign LLC. File Number: Date of Filing: Filing Fee: 1. Entity Name. 2. Organized under the laws of which state or country. 3. Name of Registered Agent and address of registered office in DC. 4. Address of principal office in the state of formation. 5. List all company's managers and members (attach list if needed). TITLE NAME ADDRESS FOREIGN LLCs: ANSWER 6-8 6. Date Organized 7. Term of existence authorized 9. Select company representative executing this form. Manager Member 8. Is company in good standing in state / country where it is organized? Yes No 10. Signature. Authorized Person If you sign anywhere on this 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