Notice Of Transaction Pursuant To Corporations Code Section 25102(F) - California Commissioner Of Corporations Page 2

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TO THE COMMISSIONER OF CORPORATIONS OF
THE STATE OF CALIFORNIA
CONSENT TO SERVICE OF PROCESS
KNOW ALL MEN BY THESE PRESENTS:
That the undersigned, ____________________________________________ (a corporation, partnership or
limited liability company organized under the laws of the State of ___________________), (an individual), (other
_________________) hereby irrevocably appoints the Commissioner of Corporations of the State of California, or the
Commissioner's successor in office, to be the undersigned's attorney to receive service of any lawful process in any
noncriminal suit, action or proceeding against the undersigned, or the undersigned's successor, executor, or
administrator which arises under the California Corporate Securities Law of 1968 or any rule or order thereunder after
this consent has been filed, with the same force and validity as if served personally on the undersigned.
For the purpose of compliance with the Corporations Code of the State of California, notice of the service and
a copy of the process should be sent by registered or certified mail to the undersigned at the following address:
__________________________________________________________________________________________
(Name and Address)
__________________________________________________________________________________________
Dated: ________________________, _________.
_________________________________________
By ______________________________________
Title _____________________________________
State of California
)
County of _____________________)
On ______________________________ before me, (here insert name and title of the officer), personally
appeared ____________________________________________ personally known to me (or proved to me on the
basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the
instrument.
WITNESS my hand and official seal.
Signature___________________________________
(Seal)
Any certificate of acknowledgement taken in another state shall be sufficient in the State of California if it is
taken in accordance with the laws of the place where the acknowledgement is made.
260.165 (Rev. 1/96)

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