Filing Fee: $10.00 ID Number: ____________ STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 100 North Main Street Providence, Rhode Island 02903-1335 BUSINESS CORPORATION ___________ STATEMENT OF REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS BY WRITTEN CONSENT OF SHAREHOLDERS (To Be Filed In Duplicate Original) Pursuant to the provisions of Section 7-1.1-81 of the General Laws, 1956, as amended, the undersigned corporationsubmits the following statement of revocation of voluntary dissolution proceedings heretofore taken upon the writtenconsent of all of its shareholders: 1. The name of the corporation is 2. The names and respective addresses of its officers are: Name Office Address President Vice President Treasurer Secretary (If more space is required, please list on separate attachment.) 3. The names and respective addresses of its directors are: Name Address (If more space is required, please list on separate attachment.) 4. The following written consent signed by all the shareholders of the corporation revoking its voluntary dissolution proceedings has been signed by all of the shareholders of the corporation, or signed in their names by their respective attorneys thereunto duly authorized. [Attach copy of signed written consent] Form No. 109 Revised: 01/99 >>>> 2Date: Print Corporate Name By _________________________________________________ President or Vice President (check one) AND By _________________________________________________ Secretary or Assistant Secretary (check one)STATE OF COUNTY OF In , on this day of , , personally appearedbefore me who, being by me first duly sworn, declared that he/sheis the of the corporation and that he/she signed the foregoing document assuch officer of the corporation, and that the statements herein contained are true. Notary Public My Commission Expires: >>>> 3 STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS Office of the Secretary of State Corporations Division 100 North Main Street Providence, Rhode Island 02903-1335 (401) 222-3040 INSTRUCTIONS FOR FILING STATEMENT OF REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS BY WRITTEN CONSENT OF THE SHAREHOLDERS Section 7-1.1-81 of the General Laws of Rhode Island, 1956, as amended1. By the written consent of all of a corporations shareholders, a corporation may, at any time prior to the issuance of a certificate of dissolution by the Secretary of State, revoke voluntary dissolution proceedings theretofore taken, by filing, in duplicate original, a Statement of Revocation of Voluntary Dissolution Proceedings by Written Consent of Shareholders (Form No. 109) with the Office of the Secretary of State, Corporations Division, at the above address. When the statements are properly completed, signed and submitted with the correct filing fee, the file stamped duplicate original shall be returned to the filer. 2. The Statement of Revocation of Voluntary Dissolution Proceedings by Written Consent of Shareholders must be accompanied by a filing fee of $10.00, and payment should be made payable to the Rhode Island Secretary of State. 3. A copy of the signed written consent of the shareholders to revoke the dissolution proceedings must be attached to the statement. 4. At the time of filing, the corporation must be in good standing and current with the filing of its annual reports and the maintenance of its registered agent and its registered office in this state. 5. The Statement of Revocation of Voluntary Dissolution Proceedings by Written Consent of the Shareholders must be signed, in duplicate original, by the corporations president or vice president and secretary or assistant secretary. A signature must appear on each line even if the same person holds both offices. The signature of one officer only must be notarized. Facsimile signatures will not be accepted If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m.Instructions/Form 109 Revised: 01/99