Certificate Of Disclosure Bankruptcy Attachment Page 2

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Second “other corporation”
Name of other corporation 2
Name of Individual 1
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
City
State
Zip
City
State
Zip
Country
Country
State(s) of Incorporation:
Name of Individual 2
State(s) of transaction of business:
Address 1
Address 2 (optional)
Dates of corporation operation:
City
State
Zip
Country
Third “other corporation”
Name of other corporation 3
Name of Individual 1
Address 1
Address 1
Address 2 (optional)
Address 2 (optional)
State
State
Zip
City
Zip
City
Country
Country
State(s) of Incorporation:
Name of Individual 2
State(s) of transaction of business:
Address 1
Address 2 (optional)
Dates of corporation operation:
State
Zip
City
Country
C005.001
Arizona Corporation Commission – Corporations Division
Rev: 2010
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