INSTRUCTIONS: 1. Use 8275224 x 11224 white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office on the web at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. (SOS use only) (If different from above 226 SOS use only) American LegalNet, Inc. www.FormsWorkFlow.com (Name of Corporation) (month, day, year) To determine if your Registered Agent is a Commercial Registered Agent (CRA), go to INBIZ.in.gov. Provide either commercial registered agent or noncommercial registered agent information below. (Do not provide address.) (number and street) (A P.O. Box is not acceptable unless accompanied by a Rural Route number.) (OPTIONAL) (Strike inapplicable section.) American LegalNet, Inc. www.FormsWorkFlow.com (title) American LegalNet, Inc. www.FormsWorkFlow.com