Form Cf:0036b - Articles Of Domestication Of A Non-Tax-Exempt Nonprofit Corporation Page 3

DATED this ______ day of ___________________, _____.

_____________________________________

[Name of Corporation]

By___________________________________

___________________________________

[Name]

[Title]

Pursuant to A.R.S. §10-3223, these Articles of Domestication are accompanied a Certificate of Disclosure, and

a Certificate of Good Standing duly authenticated by the official having custody of the corporate records in the

jurisdiction in which the corporation was originally incorporated.

Acceptance of Appointment

By Statutory Agent

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

above-named corporation effective this _______ day of _______________, _____.

Signed____________________________________

____________________________________

[Print Name Here]

[If signing on behalf of a company serving as

statutory agent, print company here]

CF:0036B

REV: 05/03

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Parent category: Legal