F The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth FPC One Ashburton Place, Boston, Massachusetts 02108-1512 FORM MUST BE TYPED DBA ATTACHMENT FORM MUST BE TYPED (General Laws Chapter 156D, Section 4.01, Section 15.06; Chapter 110, Section 5; 950 CMR 113.18) Exact name of corporation: ______________________________________________________________________________ State of incorporation: __________________________________________________________________________________ h is corporation agrees not to do business in Massachusetts under the above name while use of the name is prohibited by G. L. Chapter 156D, Section 4.01 and/or G. L. Chapter 156D, Section 15.06 where applicable to foreign corporations, or where the name is reserved in accordance with G.L. Chapter 156D, Section 4.02. Name corporation will use in the commonwealth: _____________________________________________________________ Signed b y:___________________________________________________________________________________________, (signature of authorized individual) Chairman of the board of directors, President, Other o cer, Court-appointed ? duciary, on this _________________________day of_________________________________________, _____________________. American LegalNet, Inc. www.USCourtForms.comc156ds401s1506c110s5950c11318 12/30/04