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. NOTE: This form may be used by a foreign entity that wishes to withdraw its registration to do business in Indiana. (SOS use only) (If different from above 226 SOS use only) American LegalNet, Inc. www.FormsWorkFlow.com (choose one) (month, day, year) (Please complete this Article if you selected the first box in Article I above.) Provide a mailing address and e-mail address to which service of process may be delivered. (Please complete this Article if you selected the third box in Article I above.) Provide a mailing address or e-mail address to which service of process may be delivered. American LegalNet, Inc. www.FormsWorkFlow.com