STATEMENT AND DESIGNATION
BY FOREIGN CORPORATION
(Name of Corporation)
_________________________________________________ , a corporation organized and existing under the
laws of __________________________________________ ,makes the following statements and designation:
(State or Place of Incorporation)
1. The address of its principal executive office is
2. The address of its principal office in the State of California is ____________________________________
DESIGNATION OF AGENT FOR SERVICE OF PROCESS IN THE STATE OF CALIFORNIA
(Complete either Item 3 or Item 4.)
3. (Use this paragraph if the process agent is a natural person.)
____________________________________________________ ,a natural person residing in the State of
California, whose complete address is ______________________________________________________
______________________________________, is designated as agent upon whom process directed to
this corporation may be served within the State of California, in the manner provided by law.
4. (Use this paragraph if the process agent is a corporation.)
______________________________________________________ , a corporation organized and existing
under the laws of ____________________________ , is designated as agent upon whom process directed
to this corporation may be served within the State of California, in the manner provided by law.
NOTE: Corporate agents must have complied with California Corporations Code Section 1505
prior to designation.
5. It irrevocably consents to service of process directed to it upon the agent designated above, and to service
of process on the Secretary of State of the State of California if the agent so designated or the agent's
successor is no longer authorized to act or cannot be found at the address given.
(Signature of Corporate Officer)
(Typed Name and Title of Officer Signing)
Secretary of State Form
S&DC-STOCK/NONPROFIT (REV 03/2005)