Phone: (503) 986-2200 Fax: (503) 378-4381 Application for Business Trust—Domestic and Foreign Secretary of State Corporation Division 255 Capitol St. NE, Suite 151 Salem, OR 97310-1327 FilingInOregon.com REGISTRY NUMBER: For office use only In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record. We must release this information to all parties upon request and it will be posted on our website. For office use only Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary. 1) NAME OF THE BUSINESS TRUST 2) STATE OR COUNTRY OF FORMATION 3) NAME AND STREET ADDRESS OF EACH TRUSTEE 4) NAME OF OREGON REGISTERED AGENT 5) REGISTERED AGENT'S PUBLICLY AVAILABLE ADDRESS (Must be an Oregon Street Address, which is identical to the registered agent’s business office.) 6) ADDRESS WHERE THE DIVISION MAY MAIL NOTICES 7) THE UNDERSIGNED ENCLOSES A COPY OF THE TRUST INSTRUMENT CREATING THE TRUST. 8) EXECUTION Signature 9) CONTACT NAME (To resolve questions with this filing.) Printed Name DAYTIME PHONE NUMBER Title (Include area code.) FEES Required Processing Fee $50 Confirmation Copy (Optional) $5 Processing Fees are nonrefundable. Please make check payable to “Corporation Division.” NOTE: Fees may be paid with VISA or MasterCard. The card number and expiration date should be submitted on a separate sheet for your protection. 181 (Rev. 01/06) American LegalNet, Inc. www.FormsWorkflow.com