COMMONWEALTH OF VIRGINIA LLC-1017 STATE CORPORATION COMMISSION (07/05) STATEMENT OF RESIGNATION OF REGISTERED AGENT ________________________________________________________________________ _ (name of registered agent) hereby resigns his/her/its agency appointment as the registered agent for ________________________________________________________________________ _. (name of limited liability company) _________________________________ (limited liability companys SCC ID #) The registered office of the limited liability company 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 limited liability company 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 pers on 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 LIMITED LIABILITY COMPANY The law requires each domestic and foreign limited liability company doing business in Virginia to continuously maintain in this Commonwealth a registered office and a registered agent. The limited liability company must establish a new registered office and/or a new registered agent by filing with the Commission form LLC-1016 (Statement of Change of Registered Office and/or Registered Agent). This form can be obtained from the Commissions website at www.scc.virginia.gov/division/clk/asp/fee_corp_formrequest.aspx or by contacting the Clerks Office at (804) 371-9733 or toll-free in Virginia at 1-866-722- 2551. If the limited liability company fails to promptly establish a new registered office and/or 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.USCourtForms.com>>>> 2 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/division/clk/fee_bus.htm. 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 st Building, 1 Floor, Richmond, Virginia 23219). If you have any questions, please call (804) 371-9733 or toll-free in Virginia, 1-866-722-2551. NOTE The agency appointment will be terminated, and if so provided, the registered office st discontinued, on the 31 day after the date on which the statement is filed with the Commission. See 13.1-1017 B of the Code of Virginia. American LegalNet, Inc. www.USCourtForms.com