COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. 211 : Index No. : Calendar APPLICATION FOR CERTIFICATE No. OF WITHDRAWAL : JUDICIAL SUBPOENA Plaintiff(s) (Instructions on back of application) -against- : : To the Secretary of State of Idaho Pursuant to Section 30-1-1520, Idaho Code, the undersigned Corporation hereby applies for a certificate of withdrawal from the State of Idaho, and for that :purpose submits the following statement: Defendant(s) : . . . .1. . .The name of. the.corporation is: . . . . . . . . . . . . . . . . . . . . . . . . ......... .. ........... ______________________________________________________________________________ . The name THE PEOPLE OF which STATEin Idaho is: YORK THE it used OF NEW TO ______________________________________________________________________________ . 2. It is incorporated under the laws of ___________________________________________________ . 3. It is not transacting business in the State of Idaho. GREETINGS: 4. It hereby surrenders its authority to transact business in said state. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 5. It revokes the authority of its registered agent in the State of Idaho to accept service of process and , the Honorable at the Court consents that service of process inat action, suit or proceeding based upon any cause of action located any County of in room arising in the State of Idaho during the time it was authorized to transactin the , on the day of , 20 , at o'clock business therein and at any recessed noon, may thereafter be made on it by registered or certified mail to theaction on theat theof the corporation part address listed in item or adjourned date, to testify and give evidence as a witness in this 6., below. 6. The post office address to which process against the corporation may be mailed is: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party______________________________________________________________________________ . on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. 7. It agrees to notify the Secretary of State of the State of Idaho of any change to the address in Item 6. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Customer Acct # : (if using pre-paid account) Typed Name Capacity Secretary of Office and P.O. Address State use only g:\corp\forms\corpforms\ certofwithdrawal_corp.p65 Revised 07/2002 Signature Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : INSTRUCTIONS : Plaintiff(s) Index No. Calendar No. JUDICIAL SUBPOENA -againstOptional: If the document is incorrect where can you be reached for :corrections? Note: Complete and submit the application in duplicate. : 1. Line 1 - Enter the name of the corporation exactly as it reads in the records of the Idaho Secretary of State's Office. If the corporation was required to adopt a fictitious name to avoid a conflict with an existing business, or : if the corporation had to designate a corporate ending to comply with section 30-1-401, Idaho Code, enter such Defendant(s) name in the second portion of this section (the name which it used in :Idaho). ...................................................... 2. Line 2 - Enter the domestic state of incorporation. 3. Line 3, 4 and 5 are statements which are required by Idaho Code. THE PEOPLE OF THE STATE OF NEW YORK 4. Line 6 - Enter the address to which future service of process may be mailed against the corporation. TO 5. Line 7 is a statement which is required by Idaho Code. 6. The application must be signed by an officer of the corporation. Please specify the name of the signer by typing his/her name below the signature and indicate in what capacity he/she signs. (For example: President, GREETINGS: Secretary, etc.) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , at the Court located at County of a. If the form is typed, the filing fee is $20.00. in b. If the form is,not typed, theday offee is $40.00. 20 room on the , , at o'clock in the noon, and at any recessed filing or c. If expedited service is and give evidence as a witness in this action on the part of the adjourned date, to testify requested, add $20.00 to the filing fee. 7.the Honorable Enclose the appropriate fee: d. If the fees are to be paid from the filing party’s pre-paid customer account, enter the customer account number in the indicated space. Pursuant toYour failure § 67-910(6), the this subpoena is punishable as a contempt of court and filing makeour liable to Idaho Code to comply with Secretary of State’s Office may delete a business entity will from you the party payment for the filing is not completed. on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a database if result of your failure to comply. 8. Mail or deliver to: Witness, Honorable Court Office of the Secretary of Stateday of in County, 700 West Jefferson - Basement West PO Box 83720 Boise ID 83720-0080 9. , one of the Justices of the , 20 (Attorney must sign above and type name below) If you have questions or need help, call the Secretary of State’s office at (208) 334-2301. Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com