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 ACT OF THE CORPORATION (To Be Filed In Duplicate Original) Pursuant to the provisions of Section 7-1.1-82 of the General Laws, 1956, as amended, the undersigned corporationsubmits the following statement of revocation of voluntary dissolution proceedings heretofore taken by act of thecorporation: 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 attachement.) 3. The names and respective addresses of its directors are: Name Address (If more space is required, please list on separate attachment.) 4. The resolution adopted by the shareholders of the corporation revoking its voluntary dissolution proceedings is as follows: [Insert copy of Resolution] Form No. 110 Revised: 01/99 >>>> 25. The number of shares outstanding at the time of such adoption was ; and, if the shares of any class are entitled to vote as a class state the designation and number of outstanding shares of each class. Class Number of Shares (If more space is required, please list on separate attachment.) 6. The number of shares voted for such resolution was , and the number of shares voted against such resolution was ; and, if the shares of any class are entitled to vote as a class, state the number of shares of each class voted for and against the resolution, respectively. Number of Shares Voted Class For Against (If more space is required, please list on separate attachment.) Date: 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 ACT OF THE CORPORATION Section 7-1.1-82 of the General Laws of Rhode Island, 1956, as amended1. By the act of the corporation, 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 Act of the Corporation (Form No. 110) with the Office of the Secretary of State, Corporations Division, at the above address. When the statement is properly completed, signed and submitted with the correct filing fee, the file stamped duplicate original shall be returned to the filer. 2. The Statement 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 corporate resolution 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 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 110 Revised: 01/99