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Form Do-3/dn-04/f-06 - Notice Of Change Of Registered Office Or Registered Agent, Or Both

Arkansas Secre t a ry of State

Charlie Daniels

State Capitol • Little Rock, Arkansas 72201-1094

501-682-3409 •

NOTICE OF CHANGE OF REGISTERED OFFICE

OR REGISTERED AGENT, OR BOTH

MARK ENTITY TYPE

Corporation-Profit

Limited Liability Limited Partnership

General Partnership

Corporation-Non Profit

Limited Partnership

Limited Liability Partnership

Limited Liability Company

Pursuant to the Laws of the State of Arkansas, the undersigned submits the following statement for the purpose of changing its

registered office or its registered agent, or both in the State of Arkansas. If this statement reflects a change of registered office,

this form must be accompanied by notice of such change to any and all applicable entities.

Name of corporation:

Is the entity:  Domestic or  Foreign

Name of Tax Contact:

Street address of registered office changing from:

Street Address

City, State, Zip

Street address to which registered office changing:

Street Address

City, State, Zip

(The address of the registered office and the business address of the registered agent must be identical.)

Name of registered agent changing from:

To:

hereby consent to serve as registered agent for this entity.

Successor Agent

A letter of consent from successor agent may be substituted in lieu of this signature.

A copy bearing the file marks of the Secretary of State shall be returned.

If this entity is a corporation governed by Act 576 of 1965 such change must be filed with the County Clerk of the County

in which its registered office is located, unless the registered office is located in Pulaski County, in which event no filing

with the County Clerk is required.

I understand that knowingly signing a false document with the intent to file wth the Arkansas Secretary of State is a

Class C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days.

Signature and Title of Authorized Officer

Dated:

Fee For Corporation or Limited Liability Company - $25.00

Fee For General Partnership, Limited Partnership, Limited Liability Partnership or Limited Liability Limited Partnership - $15.00

DO-3/DN-04/F-06/ “ALL” Rev. 4/06

Form Do-3/dn-04/f-06 - Notice Of Change Of Registered Office Or Registered Agent, Or Both