Request for Legal Process to be Served by the West Virginia Secretary of State Please serve the named defendant, ___________________________________________, in the attached matter according to the provision of law cited below. The fee of $20 per defendant required by W. Va. Code §59-1-2 is attached ($30 if defendant is out of U.S.). Check all applicable: §21A-5-17c Service on non-resident employer & others liable for unemployment compensation payments §29-19-14 Service on professional fund raising counsel, nonresident charitable organizations or professional solicitors soliciting contributions from people in this State §31D-5-504 & §56-3-13 Service on authorized domestic corporation §31D-15-1510 Service on authorized foreign corporation §31D-15-1510 Service on unauthorized foreign corporation §31B-1-111 & §31B-9-906 Service on authorized domestic or foreign limited liability company §33-4-12 Service on licensed insurer §33-4-13 & §33-2-22 Service on unlicensed or unauthorized foreign insurer §38-1A-7 & §38-1A-8 Service on non-resident trustee of a security trust §46A-2-137 Service on certain nonresidents under WV Consumer Credit and Protection Act §47-9-4 Service on authorized domestic or foreign limited partnership formed under §47-9, or limited liability partnership (LLP) formed under §47B-10 (see also §56-3-13a, §47B-9-6) §47-9-4 Service on unauthorized foreign limited partnership or LLP §56-3-31 Service on nonresident motor vehicle operator involved in an accident in this state, or on his/her insurer §56-3-33(a) Service on individual under the long-arm statute because the individual is: (1) Transacting business in this state (2) Contracting to supply services or things in this State (3) Causing tortious injury in this state by act or omission (see §56-3-33(4) for description of causing tortious injury) (4) Non-support of minor children (pursuant to Lozinski v. Lozinski) (5) Causing injury in this State by breach of warranty (6) Having interest in, using or possessing real property in this State (7) Contracting to insure person, property or risk located in WV at the time of contracting §38-5A-5 Service of suggestee execution as provided for in §38-5A PRINT THIS COPY, THEN CLICK HERE TO RESET. Form SP-5 Secretary of State, Bldg 1, Rm, 157K, 1900 Kanawha Blvd, E, Charleston, WV 25305-0770 American LegalNet, Inc. www.USCourtForms.com 1/05