Application To Register A Corporate or LLC Name (foreign corporation or foreign limited liability company T.11, Ch 4 & 21) Vermont Secretary of State, 81 River Street, Montpelier, VT 05609-1104. NAME of the foreign corporation (or) the foreign limited liability company: If the name applied for is the same, or deceptively similar, as a corporation that is already incorporated or authorized to transact business in this state, a written form indicating the other corporations consent and a change of name must be attached. A foreign corporation or LLC may register the name (including the trade name) of another domestic or foreign corporation or LLC if the other corporation or LLC is incorporated or authorized to transact business in this state and the foreign corporation or LLC and the applicant has merged with the other corporation or company; has been formed by reorganization of the other corporation or company; or has acquired all or substantially all of the assets, including the name, of the other corporation or company. State (or country) of origin: Address in home state: Date of incorporation/organization: Brief description of the nature of the business: Signature_____________________________Title: Date: $25.00 Fee - A certificate of good standing (no older than 30 days from application date) must be attached from the state of origin. A corporation or limited liability company whose registration is effective may qualify to do business in Vermont, by filing the proper application. The registration terminates upon qualification. Renewal for the next calendar year can be made between Oct 1 and Dec 31 of the current year. Effective date:____________________ Expires _______________unless sooner renewed. American LegalNet, Inc. www.USCourtForms.com