COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. SOUTH CAROLINA SECRETARY OF STATE Plaintiff(s) : JUDICIAL SUBPOENA FOREIGN LIMITED LIABILITY :COMPANY -against- CERTIFICATE OF CANCELLATION OF AUTHORITY TO TRANSACT :BUSINESS IN SOUTH CAROLINA : Defendant(s) TYPE OR PRINT CLEARLY IN BLACK INK : ...................................................... This foreign limited liability company in accordance with Section 33-44-1007 of the 1976 South Carolina Code of Laws, as amended, hereby cancels its authority to transact business in South Carolina by filing this certificate of cancellation. THE PEOPLE OF THE STATE OF NEW YORK 1. The name of the foreign limited liability company as filed in South Carolina is TO . 2. The foreign limited liability company was qualified in South Carolina on 3. . The foreign limited liability company is no longer transacting business in South Carolina. GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable foreign limited liability company cancelsthe authority to transact business in South at its Court 4. The located at County ofCarolina. in room , on the day of , 20 , at o'clock in the noon, and at any recessed The forwarding address which the Secretary of State may mail on the of any the or5. adjourned date, to testify and give evidence as a witness in this action a copy part of process served on the limited liability corporation is: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Date Signature Witness, Honorable Court in County, , one of the Justices of the day of , 20Name/Capacity FILING INSTRUCTIONS (Attorney must sign above and type name below) 1. File two copies of this application, the original and either a duplicate original or a conformed copy. 2. If management of this foreign limited liability company is vested in managers, a manager shall execute this certificate of Attorney(s) for cancellation of authority to transact business in South Carolina. Specify in which capacity the person is signing. 3. If space on this form is insufficient, please attach additional sheets containing a reference to the appropriate paragraph in this form, or prepare this form by computer disk, which will allow additional space to be included in the form. 4. This application must be accompanied by the filing fee of $10.00, payable to the Secretary of State. Office and P.O. Address Return to: Secretary of State PO Box 11350 Columbia, SC 29211 LLC-FOREIGN LIMITED LIABILITY COMPANY CERTIFICATE OF CANCELLAITON.doc Telephone No.: Facsimile No.: E-Mail Address: Form Revised by South Carolina Mobile Tel. No.: Secretary of State, January 2000 American LegalNet, Inc. www.USCourtForms.com