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Change Of Agent Foreign Limited Liability Company Form - Connecticut Secretary Of The State Page 2

INSTRUCTIONS FOR COMPLETION OF THE CHANGE OF AGENT FORM

Foreign Limited Liability Company

Instructions

NAME OF LIMITED LIABILITY COMPANY IN STATE OR COUNTRY OF

FORMATION: Please provide the complete name of the limited liability company.

THE NAME UNDER WHICH LIMITED LIABILITY COMPANY SHALL

TRANSACT BUSINESS IN CONNECTICUT: Provide the complete name under which

the limited liability company transacts business in Connecticut as it currently appears on

the records of the Secretary of the State if other than the name stated in item number 1.

STATE/COUNTRY OF FORMATION: Please provide the limited liability company's

state or country of formation.

APPOINTMENT OF NEW STATUTORY AGENT:

A LIMITED LIABILITY

COMPANY MAY NOT BE ITS OWN AGENT. The limited liability company may

appoint either the Secretary of the State by placing a check next to selection A or a

natural person who is a resident of Connecticut; a Connecticut corporation, limited

liability company, limited liability partnership, or statutory trust; or a foreign corporation,

limited liability company, limited liability partnership or statutory trust which has

obtained a certificate of authority to transact business in Connecticut, by completing

selection B. If the agent is a natural person, such person must provide the complete street

address of his or her business and residence. If the agent is an entity, it must provide the

address of its principal office in the block provided for "Business address" and the person

signing on its behalf must include his or her title on the signature line. The agent must

sign accepting the appointment.

EXECUTION: The document must be executed by an authorized official of the limited

liability company. That person must print or type their name, state the capacity under

which they sign and provide a signature. The execution constitutes a legal statement

under the penalties of false statement that the information provided in the document is

true.

Rev. 08/24/2007

Change Of Agent Foreign Limited Liability Company Form - Connecticut Secretary Of The State Page 2