BTA1222 (07/05) COMMONWEALTH OF VIRGINIA STATE CORPORATION COMMISSION STATEMENT OF RESIGNATION OF REGISTERED AGENT OF A BUSINESS TRUST _________________________________________________________________________ (name of registered agent) hereby resigns his/her/its agency appointment as the registered agent for _________________________________________________________________________. (name of business trust) _____________________________ (business trust's SCC ID #) The registered office of the business trust is also discontinued. (MARK THIS BOX IF APPLICABLE) The above-named registered agent hereby certifies that a copy of this statement has been mailed to the principal office of the business trust by certified mail. _________________________________________________________________________ (signature of individual serving as registered agent) (printed name) (date) OR _________________________________________________________________________ (name of business entity serving as registered agent) By: _____________________________________________________________________ (signature) (printed name and title) (date) It is a Class 1 misdemeanor for any person to sign a document he or she knows is false in any material respect with intent that the document be delivered to the Commission for filing. NOTICE TO THE BUSINESS TRUST The law requires each domestic and foreign business trust doing business in Virginia to continuously maintain in this Commonwealth a registered office and a registered agent. The business trust must establish a new registered office and/or a new registered agent by filing with the Commission form BTA1221 (Statement of Change of Registered Office/Registered Agent). This form can be obtained from the Commission's web site at www.scc.virginia.gov/clk/ElectronicFormRequest.aspx or by contacting the Clerk of the Commission at (804) 371-9733 or toll-free in Virginia at (866) 722-2551. If the business trust fails to promptly establish a new registered office/registered agent, it may ultimately have its existence or its certificate of registration to do business in Virginia canceled. FOR SCC USE Date filed: ________________________ See instructions on the reverse. American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS The statement must be in the English language, typewritten or printed in black, legible and reproducible. The document must be presented on uniformly white, opaque paper, free of visible watermarks and background logos. You can download this form from our website at www.scc.virginia.gov/clk/formfee.aspx If the registered agent is a business entity, the statement must be executed in the name of the business entity by a person authorized to act on behalf of the registered agent, and the printed name and title of the person signing on behalf of the registered agent must be set forth next to the signature. Submit the original, signed statement to the Clerk of the State Corporation Commission, P.O. Box 1197, Richmond, Virginia 23218-1197, (Street address: 1300 East Main Street, Tyler Building, 1st Floor, Richmond, Virginia 23219). If you have any questions, please call (804) 3719733 or toll-free in Virginia, 1-866-722-2551. NOTE The agency appointment will be terminated and if so provided, the registered office discontinued, on the 31st day after the date on which the statement is filed with the Commission. See § 13.1-1222 B of the Code of Virginia. American LegalNet, Inc. www.FormsWorkFlow.com