Filing Fee: $10.00 IDENTIFICATION no. ____________________ The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512 CERTIFICATE OF REVOCATION OF APPOINTMENT OF RESIDENT AGENT (General Laws, Chapter 180, Section 10C) I, _____________________________________________________________________________________ , *Clerk / *Assistant Clerk of _________________________________________________________________________________________________________ , (Exact name of corporation) having a principal office at ______________________________________________________________________________________ , (Street address of corporation in Massachusetts) certify that pursuant to General Laws, Chapter 180, Section 10C, said corporation has revoked the appointment of: ____________________________________________________________________________________________________________ (Exact name of resident agent) of ________________________________________________________________________________________________________ , (Business address of resident agent) as its resident agent and that the following is a true copy of the vote of the directors revoking such appointment: SIGNED UNDER THE PENALTIES OF PERJURY, this __________ day of________________________________ , 20 ___________, _______________________________________________________________________________________ , *Clerk / *Assistant Clerk. *Delete the inapplicable words. American LegalNet, Inc. www.FormsWorkFlow.com 180cvara 11/7/13 THE COMMONWEALTH OF MASSACHUSETTS CERTIFICATE OF REVOCATION OF APPOINTMENT OF RESIDENT AGENT (General Laws, Chapter 180, Section 10C) I hereby approve the within Certificate of Revocation of Appointment of Resident Agent and, the filing fee in the amount of $ ________________ having been paid, said certificate is deemed to have been filed with me this _________day of ___________________, 20______ . WILLIAM FRANCIS GALVIN Secretary of the Commonwealth TO BE FILLED IN BY CORPORATION Contact information: _________________________________________________________ _________________________________________________________ _________________________________________________________ Telephone: _________________________________________________ Email: __________________________________________________________ A copy this filing will be available on-line at www.state.ma.us/sec/cor once the document is filed. American LegalNet, Inc. www.FormsWorkFlow.com