State of New Hampshire APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY INSTRUCTIONS FOR COMPLETING FORM FLLC-1 (RSA 304-C:64) FIRST: Exact name of limited liability company; name must match the certificate of good standing provided by the Secretary of State from the state or country of formation. The name must exactly match the name on the certificate, including punctuation. SECOND: If the name of the limited liability company does not contain the words “Limited Liability Company”, the abbreviation “L.L.C.” or similar abbreviation, insert the name of the limited liability company with the words “Limited Liability Company”, the abbreviation “L.L.C.” or similar abbreviation. OR If the limited liability company name is not available for use in New Hampshire, enter the name to be used in New Hampshire. In this case a trade name application must be filed with an additional $50.00 fee. If the limited liability company name is available and a trade name in addition to the limited liability company name is to be used, do not enter the trade name in this space but file a trade name application with a $50.00 fee. THIRD: & FOURTH: State or country of formation and date formed in that state or country. FIFTH: Refer to RSA 304-C: 7 for nature of business permitted. SIXTH: The registered office must be the agent’s business address. If a post office box is given, the physical location of the business office must also be given. The registered agent shall be the agent of the limited liability company upon whom any process, notice or demand required or permitted by law to be served upon the limited liability company may be served. “RSA 304-C:66 II (a) & (b) II. Each foreign limited liability company shall have and maintain in New Hampshire: (a) A registered office that may be the same as any of its places of business in New Hampshire. (b) A registered agent, which agent may be either an individual resident of New Hampshire whose business office is identical with the foreign limited liability company’s registered office, or a domestic corporation, or a foreign corporation authorized to do business in New Hampshire having a business office identical with such registered office.” SEVENTH: This form must be accompanied by form SRA, certification pursuant to RSA 421-B:11, II, relative to offerings securities (generally, membership interests) for sale in New Hampshire. Please call the Bureau of Securities Regulation (603-271-1463) with any questions you may have with this requirement. Call the Corporate Division (603-271-3244) regarding any other questions concerning this application. NOTES: An ORIGINAL certificate of existence or document of similar import must accompany this application (photocopies or fax copies will not be accepted). The certificate must be duly authenticated within 60 days of the filing of this application by the proper official of the state or country under the laws of which the limited liability company was formed. (A certificate of good standing regarding taxes from a state department of revenue administration is not acceptable.) Mail fees, DATED AND SIGNED ORIGINAL, CERTIFICATE OF EXISTENCE OR DOCUMENT OF SIMILAR IMPORT ISSUED BY THE STATE OR COUNTRY OF FORMATION AND FORM SRA to: Corporate Division, Department of State, 107 North Main Street, Concord NH 03301-4989. Form FLLC-1 Instruct V1.0 American LegalNet, Inc. www.FormsWorkflow.com State of New Hampshire Filing fee: $ 50.00 Fee for Form SRA: $ 50.00 Total fees: $100.00 Use black print or type. Form FLLC-1 RSA 304-C:12 Form must be single-sided, on 8 ½ x11” paper; double sided copies will not be accepted. APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY PURSUANT TO THE PROVISIONS OF THE NEW HAMPSHIRE LIMITED LIABILITY COMPANY LAWS, THE UNDERSIGNED HEREBY APPLIES FOR REGISTRATION TO TRANSACT BUSINESS IN NEW HAMPSHIRE AND FOR THAT PURPOSE SUBMITS THE FOLLOWING STATEMENT: FIRST: The name of the limited liability company is . SECOND: The name which it proposes to register and do business in New Hampshire is . THIRD: It is formed under the laws of . FOURTH: The date of its formation is . FIFTH: The nature of the business or purposes to be conducted or promoted in New Hampshire is . SIXTH: The name of its registered agent in New Hampshire is . and the street address, town/city (including zip code and post office box, if any) of its registered office is (agent's business address in New Hampshire) . SEVENTH: The sale or offer for sale of any ownership interests in this business will comply with the requirements of the New Hampshire Uniform Securities Act (RSA 421-B). Page 1 of 2 Form FLLC-1 Page 1 V1.0 American LegalNet, Inc. www.FormsWorkflow.com APPLICATION FOR REGISTRATION AS A FOREIGN LIMITED LIABILITY COMPANY OF Form FLLC-1 (Cont.) *Signature: Print or type name: Title: Date signed: Complete address of person signing: * Shall be executed on behalf of the foreign limited liability company by a person with authority to do so under the laws of the state or other jurisdiction of its formation, or, if the foreign limited liability company is in the hands of a receiver, executor, or other court appointed fiduciary, trustee, or other fiduciary, it must be signed by that fiduciary. DISCLAIMER: All documents filed with the Corporate Division become public records and will be available for public inspection in either tangible or electronic form. Mail fees, DATED AND SIGNED ORIGINAL, CERTIFICATE OF EXISTENCE OR DOCUMENT OF SIMILAR IMPORT ISSUED BY THE STATE OR COUNTRY OF FORMATION AND FORM SRA to: Corporate Division, Department of State, 107 North Main Street, Concord NH 03301-4989. Page 2 of 2 5/07 Form FLLC-1 Page 2 V1.0 American LegalNet, Inc. www.FormsWorkflow.com