COVER LETTER TO: Amendment Section Division of Corporations SUBJECT: DOCUMENT NUMBER: Name of Corporation The enclosed Affidavit by Foreign Corporation to Change/Add Officer(s) and/or Director(s) and fee are submitted for filing. Please return all correspondence concerning this matter to the following: Name of Contact Person Firm/Company Address City/State and Zip Code E-mail address: (to be used for future annual report notification) For further information concerning this matter, please call: at ( Name of Contact Person ) Area Code & Daytime Telephone Number Enclosed is a check made payable to the Florida Department of State for the following amount: $35.00 Filing Fee $43.75 Filing Fee & Certificate of Status $43.75 Filing Fee & Certified Copy (Additional copy is enclosed) $52.50 Filing Fee, Certificate of Status & Certified Copy (Additional copy is enclosed) Mailing Address: Amendment Section Division of Corporations P.O. Box 6327 Tallahassee, FL 32314 CR2E127 (10/11) Street Address: Amendment Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 American LegalNet, Inc. www.FormsWorkFlow.com FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS AFFIDAVIT BY FOREIGN CORPORATION TO CHANGE/ADD OFFICER(S) AND/OR DIRECTOR(S) 1. The name of the foreign corporation as it appears on the records of the Florida Department of State is: 2. This entity was authorized to transact business in Florida on number is 3. This corporation was formed under the laws of 4. The name and address of each officer and/or director is as follows: Title: Name and Address and its Florida document (Attach additional pages if necessary) Signature of an officer or director Title of person signing FILING FEE $35 Make checks payable to Florida Department of State and Mail to: Division of CorporationsyPO Box 6327yTallahassee, FL 32314 Typed or printed name of person signing CR2E127 (10/11) American LegalNet, Inc. www.FormsWorkFlow.com