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Form Ss 984 - Transmittal Information For All Business Filings, Form Ss1l3 - Articles Of Organization, Form Ss973 - Limited Liability Company Initial Report Page 4

Tom Schedler

Secretary of State

LIMITED LIABILITY COMPANY INITIAL REPORT

(R.S. 12:1305 (E))

1. The name of this limited liability company is :

2. The location and municipal address, not a post office box only, of this limited liability company’s

registered office:

3. The full name and municipal address, not a post office box only, of each of this limited liability company’s

registered agent(s) is/are:

4. The names and municipal addresses, not a post office box only, of the first managers, or the members:

To be signed by each person who signed the articles of organization:

AGENT’S AFFIDAVIT AND ACKNOWLEDGEMENT OF ACCEPTANCE

I hereby acknowledge and accept the appointment of registered agent for and on behalf of the above

named limited liability company.

Registered agent(s) signature(s):

Sworn to and subscribed before me, the undersigned Notary Public, on this date:

NOTARY NAME MUST BE TYPED OR PRINTED WITH NOTARY #

Notary Signature

(see instructions on back)

SS973 Rev. 09/11

Form Ss 984 - Transmittal Information For All Business Filings, Form Ss1l3 - Articles Of Organization, Form Ss973 - Limited Liability Company Initial Report Page 4

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