COVER LETTER TO: Amendment Section Division of Corporations SUBJECT: (Name of Corporation) DOCUMENT NUMBER: The enclosed Resignation of Registered Agent for a Corporation and fee are submitted for filing. Please return all correspondence concerning this matter to the following: (Name of Person) (Name of Firm/Company) (Address) (City/State and Zip Code) For further information concerning this matter, please call: at ( (Name of Person) ) (Area Code & Daytime Telephone Number) Enclosed is a check made payable to the Florida Department of State for $87.50 for an active corporation or $35.00 for an administratively dissolved, voluntarily dissolved or withdrawn corporation. Street Address: Amendment Section Division of Corporations Clifton Building 2661 Executive Center Circle Tallahassee, FL 32301 Mailing Address: Amendment Section Division of Corporations Post Office Box 6327 Tallahassee, FL 32314 CR2E046 (04/12) American LegalNet, Inc. www.FormsWorkFlow.com RESIGNATION OF REGISTERED AGENT FOR A CORPORATION Pursuant to the provisions of sections 607.0502(2), 617.0502(2), 607.1509, or 617.1509, Florida Statutes, the undersigned, (Name of Registered Agent) hereby resigns as Registered Agent for (Name of Corporation) (Document Number, if known) A copy of this resignation was mailed to the above listed corporation at its last known address. The agency is terminated and the office discontinued on the 31st day after the date on which this statement is filed. (Signature of Resigning Agent) If signing on behalf of an entity: (Typed or Printed Name) (Capacity) Fee for filing this document: $87.50 - Active corporation $35.00 - Administratively dissolved/voluntarily dissolved/ withdrawn corporation Make checks payable to Florida Department of State and mail to: Division of Corporations P.O. Box 6327 Tallahassee, FL 32314 American LegalNet, Inc. www.FormsWorkFlow.com