Page 1 of 4Form 525ALast Revised: 06/2019 Toll Free: 877.767.3453 | Central Ohio: 614.466.3910 OhioSoS.gov | business@OhioSoS.gov File online or for more information: OhioBusinessCentral.gov Filing Form Cover LetterPlease return the approval certificate to: Address: City: ZIP Code: Phone Number: E-mail Address: Check here if you would like to receive important notices via e-mail from the Ohio Secretary of State's office regarding Business Services. Check here if you would like to be signed up for our Filing Notification System for the business entity being created or updated by filing this form. This is a free service provided to notify you via e-mail when any document is filed on your business record. Please make checks or money orders payable to: "Ohio Secretary of State" Type of Service Being Requested: (PLEASE CHECK ONE BOX BELOW) Regular Service: Only the filing fee listed on page one of the form is required and the filing will be processed in approximately 3-7 business days. The processing time may vary based on the volume of filings received by our office. Expedite Service 1: By including an Expedite fee of $100.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 2 business days after it is received by our office. Expedite Service 2: By including an Expedite fee of $200.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 1 business day after it is received by our office. This service is only available to walk-in customers who hand deliver the document to the Client Service Center. Expedite Service 3: By including an Expedite fee of $300.00, in addition to the regular filing fee on page one of the form, the filing will be processed within 4 hours after it is received by our office, if received by 1:00 p.m. This service is only available to walk-in customers who hand deliver the document to the Client Service Center. Preclearance Filing: A filing form, to be submitted at a later date for processing, may be submitted to be examined for the purpose of advising as to the acceptability of the proposed filing for a fee of $50.00. The Preclearance will be complete within 1-2 business days. Name (Individual or Business Name): To the Attention of (if necessary): State American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 4Form 525ALast Revised: 06/2019Toll Free: 877.767.3453 Central Ohio: 614.466.3910 OhioSoS.gov business@OhioSoS.gov File online or for more information: OhioBusinessCentral.gov Mail this form to one of the following: Regular Filing (non expedite) P.O. Box 788 Columbus, OH 43216 Expedite Filing (Two business day processing time. Requires an additional $100.00) P.O. Box 1390 Columbus, OH 43216 Reinstatement & Appointment of Agent For a Foreign or Domestic Corporation For Failure to Maintain a Statutory Agent (108-REN) & (111-FREA) Filing Fee: $25 Form Must Be Typed Charter or License Number Name of Corporation New Statutory Agent Name and Address All corporations must complete this section Name Mailing Address City State Zip Code Please check here to confirm that the agent is an Ohio resident, an Ohio corporation, or a foreign corporation licensed under Ohio law.Form 525A Prescribed by: For screen readers, follow instructions located at this path. American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 4Form 525ALast Revised: 06/2019 Only Domestic Corporations must complete this sectionAcceptance of Appointment, named herein as theThe Undersigned, (Name of Statutory Agent)Statutory agent for (Name of Corporation)hereby acknowledges and accepts the appointment of statutory agent for said corporation.Statutory Agent Signature (Individual Agent's Signature / Signature on Behalf of Business Serving as Agent) Print Name By (if applicable) Signature Print Name By (if applicable) Signature Print Name By (if applicable) SignatureBy signing and submitting this form to the Ohio Secretary of State, the undersigned hereby certifies that he or she has the requisite authority to execute this document.Required Reinstatement must be signed by a corporate officer, or if a nonprofit corporation, then by an officer of three members in good standing. If authorized representative is an individual, then they must sign in the "signature" box and print their name in the "Print Name" box. If authorized representative is a business entity, not an individual, then please print the business name in the "signature" box, an authorized representative of the business entity must sign in the "By" box and print their name in the "Print Name" box. American LegalNet, Inc. www.FormsWorkFlow.com Page 4 of 4Form 525ALast Revised: 06/2019Instructions for Reinstatement & Appointment of Agent This form should be used to file an application of reinstatement for a corporation whose articles have been canceled for failure to maintain a statutory agent. Entity Information The corporation must provide the name and charter or license number. Agent Information: Pursuant to Ohio Revised Code 2471701.07,1702.06, and 1703.041,a corporation must appoint and maintain a statutory agent to accept service of process on behalf of the corporation. The statutory agent must be one of the following: (1) A natural person who is a resident of this state; or (2) A domestic or foreign corporation, nonprofit corporation, limited liability company, partnership, limited partnership, limited liability partnership, limited partnership association, professional association, business trust, or unincorporated nonprofit association that has a business address in this state. If the agent is a business entity then the agent must meet the requirements of Title XVII of the Revised Code to transact business or exercise privileges in Ohio. The statutory agent must also sign the Acceptance of Appointment on page 2. Additional Provisions If the information you wish to provide for the record does not fit on the form, please attach additional provisions on a single-sided, 8 1/2 x 11 sheet(s) of paper. Signature(s) After completing all information on the filing form, please make sure that the form is signed. If the applicant is a corporation, the reinstatement form must be signed by a corporate officer. If the applicant is a nonprofit corporation, the reinstatement form must be signed by an officer or three members in good standing. **Note: Our office cannot file or record a document that contains a social security number or tax identification number. Please do not enter a social security number or tax identification number, in any format, on this form. Instructions for Reinstatement & Appointment of Agent American LegalNet, Inc. www.FormsWorkFlow.com