Statement Or Plan Of Interest Exchange Of Domestic Filing Entity {GN-9}

Mail all forms and required payment to: Department of Consumer and Regulatory Affairs Corporations Division PO Box 92300 Washington, DC 20090 Phone: (202) 442 - 44 32 Corporate Online Services Information: Many corporate filings are available by using CorpOnline Service. Go to CorpOnline site at https://corp online .dcra.dc.gov , create the profile, access the online services main page and proceed. Online filers must pay by using the credit card. District of Columbia Government Corporations Division Statement /Plan of Interest Exchange of Domestic Filing Entity . Form G N - 9 , Ver. 2 , April 2018 . r This form will allow for a domestic entity to acquire all of one or more classes or series of interests of another domesticoforeign entity in exchange for interests, securities, obligations, rights to acquire interests or securities, cash, orother property or any combination of the foregoing. ENTITY TYPE FILING F E E Domestic Filing Entity Refer to Corporate Fee Schedule posted online; Under the provisions of the Title 29 of D.C. Code (Business Organizations Act), the domestic filing entity listed below hereby applies for a Certificate of Interest Exchange and for that purpose submits the statement below. 1.1. The name and type of the acquired entity. 2. The name, jurisdiction of organization, and type of the acquiring entity. 3. Effective date . (may not be more than 90 days after the date of filing) 4. The plan of interest exchange was approved by the acquired entity in accordance with D.C. Code 247 29 - 203.05. 5. Attach any amendments to the acquired entity's public organic document approved as part of the plan of interest exchange. If you sign this form you agree that anyone who makes a false statement can be punished by criminal penalties of a fine up to $1000, imprisonment up to 180 days, or both, under DCOC 247 22 - 2405; 6 . Name of th e Governor or Authorized Person. 6A . Si gnature of the Governor or Authorized Person . 7 .Name of the Governor or Authorized Person. 7A . Signature of the Governor or Authorized Person. American LegalNet, Inc. www.FormsWorkFlow.com