MSC.1 FEDERAL IDENTIFICATION NO. _____________________ Fee: $40.00 The Commonwealth of Massachusetts Examiner William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Boston, Massachusetts 02108-1512 APPLICATION FOR REVIVAL (General Laws, Chapter 180, Section 10C) 1. Exact name of corporation is: 2. Name of applicant is: 3. Address of applicant is: 4. State fully the applicant’s relationship to, or interest in, the corporation: 5. Date of dissolution or revocation of charter of the corporation is: 6. The corporation was dissolved or the charter was revoked under the provisions of General Laws, Chapter 180, Section __________ . 7. Describe fully the circumstances leading to the dissolution or revocation: P.C. American LegalNet, Inc. www.USCourtForms.com 180arev 4/5/00 8. Describe fully the activities, if any, of the corporation since dissolution or revocation of the charter: 9. Does the applicant seek a limited or general revival? If limited, state fully the reason(s) therefore, and period of time (not exceeding one year) sought for the revival: SIGNED UNDER THE PENALTIES OF PERJURY, this ___________ day of _______________________________ , 20 _________ , ______________________________________________________________________________________ , Signature of Applicant. I hereby approve the within Application for Revival and, the filing fee in the amount of $ _________ having been paid, said application is deemed to have been filed with me this _____ day of _________________ , 20 _____ . WILLIAM FRANCIS GALVIN Secretary of the Commonwealth American LegalNet, Inc. www.USCourtForms.com