COMMONWEALTH OF KENTUCKY TREY GRAYSON SECRETARY OF STATE STATEMENT OF CHANGE OF REGISTERED OFFICE OR REGISTERED AGENT OR BOTH Pursuant to the provisions of KRS Chapter 386, the undersigned hereby applies to change the registered office or registered agent, or both on behalf of the business trust named below and for that purpose submits the following statements: 1. The name of the business trust is _____________________________________________________________________________________________. (Exact name of business trust) 2. The state or country or establishment is _____________________________________________________________. 3. The street address of the current registered office on file with the Secretary of State is _____________________________________________________________________________________________. Street City/State Zip Code 4. The street address of the registered office is hereby changed to _____________________________________________________________________________________________. Street City/State Zip Code 5. The name of the current registered agent on file with the Secretary of State is _____________________________________________________________________________________________. 6. The name of the registered agent is hereby changed to ______________________________________________________________________________________________. 7. The street address of the registered office and the business office of the registered agent, as changed, is identical. _____________________________________________ Signature _____________________________________________ Type or Print Name & Title Date: _____________________________, 20_________ I, ______________________________________ consent to serve as the registered agent on behalf of the business trust. Type or print name of registered agent _______________________________________________ Signature of Registered Agent _______________________________________________ Type or Print Name & Title, if applicable FBT-101 (2/98) (See attached sheet for instructions) American LegalNet, Inc. www.USCourtForms.com Statement of Change of Registered Office or Registered Agent or Both Filing Instructions NAME OF BUSINESS TRUST Use the exact name of the business trust as filed with the Secretary of State. REGISTERED OFFICE ADDRESS State the complete address of the current registered office on file with the Secretary of State. If the current registered office address is being changed, state the complete street address as changed. The registered office address must be a Kentucky address and contain a street or other specific location. (Highway, Rural Route, Apartment, Public Building, etc.) A mailing address consisting of only a post office box is not sufficient for the registered office address. REGISTERED AGENT AND CONSENT OF APPOINTED REGISTERED AGENT State the name of the current registered agent on file with the Secretary of State. If the current registered agent is being changed, state the name of the individual or corporation as changed. The registered agent may be an individual resident of Kentucky, a Kentucky corporation, a Kentucky nonprofit corporation or a foreign corporation, or a foreign nonprofit corporation authorized to transact business in Kentucky. The appointed registered agent must give written consent to act as agent and, if a corporation (foreign or domestic) is the newly appointed agent, the corporate representative must state his or her title or the capacity in which he or she signs. WHO MAY SIGN The statement of change of registered office or registered agent or both must be signed by a trustee. NUMBER OF COPIES Submit the original signed statement and two exact or conformed copies. (May be photocopies). Two file-stamped copies will be returned to the business trust as evidence of filing. One file-stamped copy must then be filed with the county clerk of the county in which the business trust’s registered office is situated. FILING FEES The filing fee is $15.00. Your check should be made payable to “Kentucky State Treasurer.” MAILING ADDRESS Trey Grayson Secretary of State P. O. Box 718 Frankfort, KY 40602-0718 OFFICE LOCATION Room 154, Capitol Building 700 Capital Avenue Frankfort, KY 40601 WEB SITE ADDRESS Our home page address is: //www.sos.state.ky.us Click on “On Line Business Database” for information on status of all business entities in Kentucky. Forms are also available on our web site. For more information, please call (502) 564-2848, press 2, and then press 5 or try our web site. American LegalNet, Inc. www.USCourtForms.com