COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : APPLICATION FOR AMENDED CERTIFICATECalendar No. OF AUTHORITY (profit or non-profit T.11A-B, §15.04) : JUDICIAL SUBPOENA Plaintiff(s) -againstName as qualified in Vermont : : A corporation created and existing under the laws of the state (country) of: : Date of incorporation: Duration (if not purpetual): Defendant(s) : ...................................................... NAME OF REGISTERED AGENT: Registered office address: THE PEOPLE OF THE STATE OF NEW YORK City TO Principal Office Address: VERMONT Zip Code City State Zip Code GREETINGS: OFFICERS / DIRECTORS NAMES AND ADDRESSES: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Add , at the Court located atAdd County of V.P. in room , on the day of , 20 , at o'clock in the noon, and at any recessed Sec Add or adjourned date, to testify and give evidence as a witness in this action on the part of the Pres Honorable the Trea Add Dir Add Add 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 name is changed The corporatefailure to comply. to: Dir Witness, Honorable Court in County, , one of the Justices of the day of State of Incorporation is changed to: , 20 Duration is changed to: Signature__________________________________________Title________________Date__________ (Attorney must sign above and type name below) A certificate of good standing (dated no earlier than 30 days prior to filing) MUST be attached from the state of origin. Please file in duplicate. Attorney(s) for FEE: $25.00 Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com