MINNESOTA SECRETARY OF STATE FOREIGN CORPORATION ANNUAL RENEWAL Minnesota Statutes Chapter 303 Must be filed by December 31 Filing Fee: $115.00 READ THE INSTRUCTIONS BEFORE COMPLETING THIS FORM 1. File#: 2. Governed under the laws of the State of: 3. Corporate Name Used in Minnesota: (Required) 4. Legal Name in State of Incorporation: 5. Registered Agent/ Registered Office Address in Minnesota : (Required) Agent Name: _________________________________________________________________________________ Street: ______________________________________________________________________________________ City: _________________________________________ State: MN Zip:________________________________ Name and business address of C.E.O. (Chief Executive Officer): (Required) 6. Name: __________________________________________________________________________________ Street: ______________________________________________________________________________________ City:________________________________________State:_______________________ Zip:_________________ 7. Does this corporation own, lease, or have any financial interest in agricultural land or land capable of being farmed? Yes_____ No _____ 8. Name, daytime telephone number and e-mail address of contact person for the corporation: Name: __________________________________Phone: (_____ )_________________________ Ext. __________ E-Mail Address: ______________________________________________________________________________ NOTICE: Failure to file this form by December 31 of this year will result in the revocation of this corporation without further notice from the Secretary of State, pursuant to Minnesota Statutes, section 303.17. American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS All foreign corporations, excluding nonprofits, governed under Minnesota Statutes Chapter 303 are required to file an annual renewal once every calendar year. A foreign corporation that has been revoked may reinstate its Certificate of Authority to Transact Business in Minnesota by completing and returning a Reinstatement Application ($300.00 fee), past due annual renewals ($115.00 fee per annual) and the annual renewal and $115.00 fee due for the year of reinstatement. PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK. 1. File Number: Provide the file number issued by the Minnesota Secretary of State. 2. Governed under the Laws of the State of: (Required) List the State under the laws of which the corporation is governed. 3 - 4. Corporate Name: (Required) If the corporate name has changed, an amendment changing the name is required to be filed with our office with an additional $50.00 filing fee. Submit the amendment with the annual renewal for filing. 5. Registered Agent, if any and Registered Office Address: (Required) If changes to the registered agent or registered office are necessary a "Notice of Change of Registered Office/Agent" form and an additional $50.00 filing fee is required. Submit the “Notice of Change of Registered Office/Agent form with the annual renewal for filing. 6. Name and Business Address of Chief Executive Officer: (Required) Fill in the name and complete business address of the Chief Executive Officer or other person who carries out the functions as C.E.O. of the corporation. 7. Does the corporation own, lease, or have any financial interest in agricultural land or land capable of being farmed? This question is optional. Check Yes or No. 8. Name, daytime telephone number and e-mail address of contact person for the corporation: Please list a name, daytime telephone number and e-mail address of a person who can be contacted about this form. Filing Fee: $115.00 Payable to the MN Secretary of State If this form is being mailed with a Reinstatement Application or an amendment, please submit all items together and mail to the address below: FILE IN-PERSON OR MAIL TO: Minnesota Secretary of State - Renewals Retirement Systems of Minnesota Building 60 Empire Drive, Suite 100 St Paul, MN 55103 (Staffed 8:00 - 4:00, Monday - Friday, excluding holidays) To obtain a copy of a form you can go to our web site at www.sos.state.mn.us , or contact us between 9:00am to 4:00pm, Monday through Friday at (651) 296-2803 or toll free 1-877-551-6SOS (6767). All of the information on this form is public. Minnesota law requires certain information to be provided for this type of filing. If that information is not included, your document may be returned unfiled. This document can be made available in alternative formats, such as large print, Braille or audio tape, by calling (651)296-2803/voice. For a TTY/TTD (deaf and hard of hearing) communication, contact the Minnesota Relay Service at 1-800-627-3529 and ask them to place a call to (651)2962803. The Secretary of State's Office does not discriminate on the basis of race, creed, color, sex, sexual orientation, national origin, age, marital status, disability, religion, reliance on public assistance or political opinions or affiliations in employment or the provision of service. ForeignCorpRenewalRev.09/06/11 American LegalNet, Inc. www.FormsWorkFlow.com