Form 3205 (Revised 03/15) Submit to: Secretary of State Registrations Unit P.O. Box 13550 Austin, TX 78711-3550 512 475-0775 FAX: 512 475-2815 This space reserved for office use. Appointment of the Secretary of State as Agent of Service THE STATE OF ____________________ } KNOW ALL MEN BY THESE PRESENTS COUNTY OF ______________________ } That________________________________________________________________, a telephone solicitation seller in the state of ____________________, does hereby irrevocably designate, constitute and appoint the Secretary of State of the State of Texas and any successors in office, the authorized agent and attorney-in-fact of the above-named seller for the purpose of accepting service for it and being served for it with citation in any non-criminal suit, action, or proceeding against said seller or the seller's successor, executor, or administrator that may arise under the Texas Occupations Code, Chapter 1803. ___________________________________ (Signature & Title) ____________________________________ (Signature & Title) ___________________________________ (Typed or Printed Name) _____________________________________ (Typed or Printed Name) ___________________________________ (Signature & Title) _____________________________________ (Signature & Title) ___________________________________ (Typed or Printed Name) _____________________________________ (Typed or Printed Name) State of ______________________ County of ____________________ American LegalNet, Inc. www.FormsWorkFlow.com Sworn to and subscribed before me on the ______ day of ____________________, ________. _____________________________________ Notary Public Signature (seal) ____________________________________ (Printed Name) My commission expires ___________________ Form #3205 American LegalNet, Inc. www.FormsWorkFlow.com