New Mexico Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us American LegalNet, Inc. www.FormsWorkFlow.com American LegalNet, Inc. www.FormsWorkFlow.com SUBMIT AN ORIGINAL $50 FEE STATEMENT OF INTENT TO DISSOLVE BY WRITTEN CONSENT OF SHAREHOLDERS Pursuant to Section 53-16-2 NMSA 1978 of the New Mexico Business Corporation Act, the undersigned corporation submits the following statement of intent to dissolve the corporation upon written consent of all its shareholders: ARTICLE ONE: The name of the corporation and the Business ID # are: ARTICLE TWO: The name(s) and address(es) of its officer(s) is (At least one officer must be listed. Attach a page if needed): ARTICLE THREE: The name(s) and address(es) of its director(s) is (At least one director must be listed. Attach a page if needed): ARTICLE FOUR: The following written consent to dissolution of the corporation has been signed by all shareholders or signed in their names by their respective attorneys authorized to consent on their behalf or a copy of the shareholder222s written consent is attached. New Mexico Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us American LegalNet, Inc. www.FormsWorkFlow.com We, the undersigned shareholders, hereby give our written consent to the dissolution of the corporation named in the Statement of Intent to Dissolve. Signature of each shareholder: American LegalNet, Inc. www.FormsWorkFlow.com SOS TC 10/13 Date: The exact name of the entity as registered with our office is: Taxation and Revenue ID SUBJECT: Tax Clearance Request for Dissolution/Withdrawal This entity is in the process of dissolving/withdrawing from the State of New Mexico and is requesting tax clearance. FINAL DAY OF BUSINESS: Month Day Year NOTE: The entity cannot be issued a Tax Clearance for a future date or if it is delinquent in filing reports and/or paying fees due. A final report may be required through the final day of business, you will be advised accordingly. Signature of Officer or Authorized Agent NAME: ADDRESS: CITY: ST: ZIP CODE: TELEPHONE: EMAIL ADDRESS: MAIL TO: Secretary of State-Tax Compliance Section 325 Don Gaspar, Suite 300, Santa Fe NM 87501 Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us New Mexico American LegalNet, Inc. www.FormsWorkFlow.com DOCUMENT DELIVERY INSTRUCTION FORM (You must have one Document Delivery Instruction Form for each filing being submitted) Entity Name: Mailing Address (Include city, state and zip code): Contact Name: Contact Phone Number: Contact Email: IF YOU HAVE SELECTED TO PICK UP YOUR DOCUMENTS, OUR OFFICE WILL CONTACT YOU WHEN YOUR DOCUMENTS ARE COMPLETED AND READY FOR PICK UP. DOCUMENTS WILL NOT BE HELD FOR MORE THAN 5 BUSINESS DAYS. IF YOU HAVE NOT PICKED THEM UP WITHIN THAT TIME FRAME, THEY WILL BE MAILED TO THE ADDRESS LISTED ABOVE. PLEASE CONTACT OUR OFFICE AT 800-477-3632 AND NOTIFY US IF YOU ARE NOT ABLE TO PICK THEM UP WITHIN THAT TIME FRAME. ---THANK YOU New Mexico Secretary of State Business Services Division 325 Don Gaspar, Suite 300 267 Santa Fe, NM 87501 (800)477-3632 267 www.sos.state.nm.us Please check how the documents are to be delivered Will Pick Up Mail to Address Above American LegalNet, Inc. www.FormsWorkFlow.com