NOTICE OF TERMINATION OF FICTITIOUS NAME The Fictitious Name, , published in Fictitious Name Book Page and which was assumed and used by has been terminated, and is no longer being used by said party(s). This notice is provided by the undersigned: Signature: Printed Name: Address: Signature: Printed Name: Address: STATE OF COUNTY/CITY OF , to-wit: I, , a Notary Public in and for the aforesaid, whose commission expires on the day of , , do hereby certify that whose name(s) is signed above, personally appeared before me and acknowledged the same on the day of , . Notary Public VIRGINIA: In the Clerk's Office of the Circuit Court in the City of Chesapeake, on the day of , . This certificate was this day received and upon certificate of acknowledgment thereto annexed, admitted to record. Teste: , CLERK By: D.C. American LegalNet, Inc. www.FormsWorkFlow.com