9. a. The purpose for which for which the Business Trust is formed is as follows: FILE ONE ORIGINAL (Two if you want a filed stamped copy returned to you.)FILING FEE: $50 * Fee Waived for Veteran-owned organizationControl # **** One original copy of the declaration, articles, or agreement of trust creating the Business Trust **** should accompany this application as set forth by West Virginia Code 24747-9A-2 . 1. The name of the Business Trust is:2. Check and complete the appropriate organizational information: It is organized under the laws of West Virginia.It was organized under the laws of: on the following date:(State) 3. Principal office address of the Business Trust: Located in the County of (required): Zip Code: State: City: Street: County: Zip Code: State: City: Street: 4. Mailing address of the Business Trust, if different from the address above: Zip Code: State: City: Street: Name: 5. Agent name and address to whom Notice for Service of Process may be sent: b. Located in how many West Virginia counties? If "Yes"... a. How many businesses? Yes No Decline to answer* Answer a. and b. below. 8. Do you own or operate more than one business in West Virginia? 7. Website address of the business, if any (ex: yourdomainname.com): 6. E-mail address where business correspondence may be received: West Virginia Secretary of State Business & Licensing Division Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.govForm BT-1 Rev. 11/2017APPLICATION FOR BUSINESS TRUST American LegalNet, Inc. www.FormsWorkFlow.com 10. The names and addresses of all trustees having authority to act on behalf of the Business Trust (attach additional pages if necessary.): Name Address City State Zip Code a) b) c) d)APPLICATION FOR BUSINESS TRUSTPage 2 The business trust hereby consents to the recognition of the application to the business trust of the laws of this state with respect to corporations.11. Read and check the following box: *Important Legal Notice Regarding Signature: Per West Virginia Code 24731D-1-129. Penalty for signing false document. Any person who signs a document he or she knows is false in any material respect and knows that the document is to be delivered to the secretary of state for filing is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one thousand dollars or confined in the county or regional jail not more than one year, or both. Important Note: This form is a public document. Please do NOT provide any personal identifiable information on this form such as social security number, bank account numbers, credit card numbers, tax identification or driver's license numbers. Date: c. Signature: b. Print name of person who is signing these articles: Phone: a. Contact person to reach in case there is a problem with filing: 13. Contact and Signature Information* (See below Important Legal Notice Regarding Signature):12. Is the organization a "veteran-owned" organization? Per WV Code 59-1-2(j) effective July 1, 2015, the registration fee is waived for entities that meet the requirements as a "veteran-owned" organization. See attached instructions to determine if the organization qualifies for this waiver. In addition, a "veteran-owned" entity will have four (4) consecutive years of Annual Report fees waived AFTER the organization's initial formation [see WV Code 59-1-2a(m) ].National Personnel Records Center Military Personnel Records 1 Archives Drive St. Louis, MO 63138 Toll free: 1-86-NARA-NARA or 1-866-272-6272 Phone: 314-801-0800 www.archives.gov/veterans/military-service-recordsYou may obtain a copy of your Veterans Affairs Form DD214 by contacting: CHECK BOX indicating you have attached Veteran Affairs Form DD214 Yes (If "Yes," attach Form DD214) No Effective JULY 1, 2015, to meet the requirements for a 223veteran-owned224 organization, the entity filing the registration must meet the following criteria per West Virginia Code 24759-1-2a : 1. A 223veteran224 must be honorably discharged or under honorable conditions, and 2. A 223veteran-owned business224 means a business that meets one of the following criteria: o Is at least fifty-one percent (51%) unconditionally owned by one or more veterans; or o In the case of a publicly owned business, at least fifty-one percent (51%) of the stock is unconditionally owned by one or more veterans. American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR FILING APPLICATION FOR BUSINESS TRUST BEFORE you fill out the application: The association name you select will be approved only if it is available - that is, if the name is not the same as and is distinguishable from any other name which has been reserved or registered with the West Virginia Secretary of State. If you prepare association papers without applying for and receiving a Name Reservation [Form NR-1 ] (for a domestic, West Virginia formed entity) or a Name Registration [Form NR-2 ] (for a foreign, out-of-State formed entity), you do so at your own risk. A telephone check for name availability is NOT a guarantee the name will be available when the application is received by our office. You may apply for a Name Reservation or Name Registration, depending on the State of origin of the trust, in writing, accompanied by a $15 fee payable to the Secretary of State, mailed to the address on the top of the application. Name Reservations (domestic entities) will be held for 120 days from the effective date of filing in our office. Name Registrations (foreign entities) are effective from the date of filing in our office until December 31 of that same filing calendar year. If you plan to do business under any other name, other than the name on your certificate of business trust, you must register that Trade Name (DBA) [Form NR-3 ] with the Secretary of State. Failure to do so could result in a fine or imprisonment. FILLING OUT THE APPLICATION Section 1. Enter the exact name of the Business Trust. The name may not contain any word or phrase which implies that it is organized for any purpose other than those contained in this application, and may not contain a word indicating it is incorporated. Section 2. Indicate by checking the appropriate box whether the trust is organized in West Virginia or in another state. If organized in another state, enter the state abbreviation in the space provided and the date of organization in the home state. Section 3. List the principal office address of the business trust. Be sure to enter the West Virginia County information where the business is located if a domestic, West Virginia-formed entity. If an out-of-state entity, enter "Out-of-State." If located in a foreign country, enter "Foreign Country." Section 4. List the principal mailing address of the business trust, if different from the principal office address in Section 3 above. Section 5. Unless you name a person or business as 223agent of process224 who can receive service of a summons or complaint, legal process will go to the address listed in #2. You may change 223agent of process224 by filing with the Secretary of State an application to appoint or change address, agent or officers [Form AAO] (fee $15). Section 6. List an e-mail address (yourname@domainname.com) where you can receive important e-mail notifications (e.g., Annual Report notices). Section 7. List the website address (domainname.com) of the business, if any. DO NOT list a physical mailing address. Section 8 Indicate whether or not you own or operate more than one business in West Virginia. If 223Yes"... a. List the total number of businesses in West Virginia in the space provided. b. List the total number of counties in West Virginia in which the businesses conduct operations.Section 9. It is important to describe the purpose(s) [i.e., principal activity(ies) to be conducted by the organization] for which the business trust is formed to insure you receive all the necessary information about registering with the required state agencies. Attach an additional page if necessary. Section 10. The names and addresses of all trustees having authority to act on behalf of the business trust are required to be entered. Attach additional pages if necessary. Sec