Form Pa - Corporate Annual Report Page 2

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10. Franchise Fee (Figure from computation work sheet line 8)
$
Minimum fee is $20; maximum fee is $2,500. Make check payable to Secretary of State ..................................
Perjury is intentionally, knowingly and falsely subscribing as true and correct under penalty of perjury any
statements given in this report. Perjury is a severity level 9, nonperson felony, which carries a sentence of
six months imprisonment and a fine not exceeding $100,000.

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