STATE OF SOUTH CAROLINA SECRETARY OF STATE NOTICE OF TRANSFER OF A RESERVED LIMITED LIABILITY COMPANY NAME TYPE OR PRINT CLEARLY IN BLACK INK Pursuant to Section 33-44-106(b) of 1976 South Carolina Code of Laws, as amended, notice is hereby given that the undersigned has transferred to ____________________________________________________________________________________ whose address is _____________________________________________________________________ ____________________________________________________________________________________ City State Zip Code Street Address the following reserved Limited Liability Company name ____________________________________________________________________________________ which name was reserved in the Office of the Secretary of State for the exclusive use of the undersigned on _________________________________________________________________________________ Date of filing for a period of one hundred twenty days after such filing date. Date ______________________ ______________________________________ Name of Original Applicant ______________________________________ Signature ______________________________________ Type or Print Name FILING INSTRUCTIONS 1. 2. 3. File two copies of this application, the original and either a duplicate original or a conformed copy. If space on this form is insufficient, please attach additional sheets containing a reference to the appropriate paragraph in this form, or prepare this using a computer disk, which will allow additional space to be included in the form. This application must be accompanied by the filing fee of $10.00, payable to the Secretary of State. Return to: Secretary of State 1205 Pendleton Street, Suite 525 Columbia SC 29201 Form Revised by South Carolina Secretary of State, May 2011 American LegalNet, Inc. www.FormsWorkFlow.com