Form Cf:0026 - Application For New Authority To Transact Business In Arizona

Form Cf:0026 - Application For New Authority To Transact Business In Arizona - 2010 Page 3

DO NOT PUBLISH

THIS SECTION

9. The foreign corporation has issued _________________ shares, itemized as follows:

9. The total number

of shares issued

_________________ shares of ______________________[class or series] stock at

cannot be blank or

_________________ no par value or par value of $ _________________ per share.

“N/A”. If no shares

have been issued,

_________________ shares of ______________________[class or series] stock at

put the word “none”

or “zero” or the

_________________ no par value or par value of $ _________________ per share.

number 0. Include

_________________ shares of ______________________[class or series] stock at

only shares actually

issued.

_________________ no par value or par value of $ _________________ per share.

The Application

must be

10. The character of business the foreign corporation initially intends to conduct in Arizona is:

accompanied by

the following:

A Certificate of

___________________________________________________________________

Disclosure, signed

within 30 days of

its delivery to the

Dated this ___________________ day of _____________________________,__________.

Commission, by

a duly authorized

officer.

A certified copy

Signature:

_________________________________________________________

of your articles of

[must be signed by a duly authorized Officer]

incorporation, all

amendments and

mergers (AZ

_________________________________________________________

Const. Art. XIV,

[print name]

[title]

§8) and a

certificate of

existence or

document of

PHONE

______________________

FAX _________________

similar import

[optional]

duly

authenticated

(within 60 days of

delivery to the

ACCEPTANCE OF APPOINTMENT BY STATUTORY AGENT

A.C.C. ) by the

The undersigned hereby acknowledges and accepts the appointment as statutory agent of this

official having

custody of

corporation effective this ____________day of ____________________________._________.

corporate records

in the state or

country under

___________________________________________

Signature

whose laws

the corporation is

___________________________________________

incorporated.

[Print Name]

The agent must

consent to the

___________________________________________

appointment by

[If signing on behalf of a company serving as

signing the

statutory agent, print company name here]

consent.

CF:0026

Arizona Corporation Commission

Rev: 04/2010

Corporations Division

Page 4 of 4

Form Cf:0026 - Application For New Authority To Transact Business In Arizona - 2010 Page 3

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