* Signature and title of person signing for the corporation. Must be signed by chairman of the board of directors, president or other officer; or see RSA 293-a:1.20(f) for alternative signatures. DISCLAIMER: All documents filed with the Corporation Division become public records and will be available for public inspection in either tangible or electronic form. MAIL DATED AND SIGNED ORIGINAL WITH CERTIFICATE OF FORMATION OF NEW HAMPSHIRE LIMITED LIABILITY COMPANY (FORM LLC-1), AND TOTAL FEES OF $135.00 to: Mailing Address - Corporation Division, NH Dept. of State, 107 N Main St, Rm 204, Concord, NH 03301-4989 Physical Location - State House Annex, 3rd Floor, Rm 317, 25 Capitol St, Concord, NH Form C-1 (9/2015) State of New Hampshire . (date) THIRD: The name of the limited liability company as set forth in its certificate of formation: . FOURTH: The number of votes cast for the plan by each voting group was sufficient for approval by each voting group. at (business address) and a copy of the plan of conversion will be furnished by (name of limited liability company) on request and without cost, to any shareholder of . (name of corporation) (Corporate name) (*Signature) (Print or type name) (*Title) Date signed: American LegalNet, Inc. www.FormsWorkFlow.com State of New Hampshire PLEASE NOTE: American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 Form LLC-1 State of New Hampshire Filing fee: $100.00 Form LLC-1 Use black print or type. RSA 304-C:31 CERTIFICATE OF FORMATION NEW HAMPSHIRE LIMITED LIABILITY COMPANY THE UNDERSIGNED, under the New Hampshire Limited Liability Company Laws submits the following certificate of formation: FIRST: The name of the limited liability company is . Principal Business Information: Principal Office Address: (no. & street) (city/town) (state) (zip code) Principal Mailing Address (if different): (no. & street) (city/town) (state) (zip code) Business Phone: Business Email: Please check if you would prefer to receive the courtesy Annual Report Reminder by email. SECOND: Describe the nature of the primary business or purposes (and if known, list the NAICS Code and Sub Code): . THIRD: The name of the limited liability company's registered agent is: . The complete address of its registered office (agent's business address) is: . (no. & street) (city/town) (state) (zip code) FOURTH: The management of the limited liability company vested in a manager or managers. American LegalNet, Inc. www.FormsWorkFlow.com American LegalNet, Inc. www.FormsWorkFlow.com