COMMONWEALTH OF KENTUCKY TREY GRAYSON, SECRETARY OF STATE _________________________________________________________________________________________________________ Division of Corporations Business Filings PO Box 718 Frankfort, KY 40602 (502) 564-3490 www.sos.ky.gov Statement of Change POC Principal Office Address ______________________________________________________________________________ Pursuant to the provisions of KRS 271B, 273, 275, or 362, the undersigned hereby applies to change the principal office address on behalf of: (The name must be identical to the name on record with the Secretary of State.) 1. Address of current principal office 2. Principal office is hereby changed to 3. Signature of officer or chairman of the board member, manager or partner _________________________________ Signature and title _________________________________ Type or print name and title _________________________________ Date (09/09) American LegalNet, Inc. www.FormsWorkFlow.com FILING INSTRUCTIONS STATEMENT OF CHANGE OF PRINCIPAL OFFICE ADDRESS NAME Use the exact name of the business entity as registered on file with the Office of the Secretary of State. PRINCIPAL OFFICE ADDRESS The principal office is the office (in or out of this state) so designated in writing with the Office of the Secretary of State where the principal designated office of the business entity is located. DOCUMENT DELIVERY All documents will be sent to the return address on the outer envelope. If no address is found, the documents will be sent to the principal office. If the applicant wishes for correspondence from the Office of the Secretary of State to be sent to someone other than those above, a request must be submitted in writing affirming that request. All other communication and notification shall follow the process prescribed in Kentucky Revised Statute. WHO MAY SIGN The document must be signed by an officer, chairman of the board, member, manager or a partner. NUMBER OF COPIES When filing online with the FastTrack system, no copies are required. If filing via mail or in person, one exact copy of the document with the filing fee must be submitted to the address below. To make a copy of the filing for delivery to the local county clerk's office, visit www.sos.ky.gov and print a copy from the organization search tool. FILING FEE The filing fee for this document is $10.00 for profit corporations, limited liability companies, limited partnerships, and limited liability partnerships and $5.00 for non-profits. Checks should be made payable to the "Kentucky State Treasurer." MAILING ADDRESS Trey Grayson Office of the Secretary of State OFFICE LOCATION Room 154, Capitol Building 700 Capital Avenue P. O. Box 718 Frankfort, KY 40601 Frankfort, KY 40602-0718 Hours of Operation: 8:00 AM-4:30 PM ET CONTACT INFORMATION If you have any questions, please feel free to visit our website at www.sos.ky.gov or call 502-564-3490. (09/09) American LegalNet, Inc. www.FormsWorkFlow.com