Nonprofit Corporations Designation Of Principal Office Address {N-11}

BUSINESS REGISTRATION DIVISION P.O. BOX 29622 Raleigh, NC 27626-0622 (Revised August 2017) Form N-11 State of North Carolina Department of the Secretary of State NONPROFIT CORPORATION222S DESIGNATION OF PRINCIPAL OFFICE ADDRESS Pursuant to 24755A-16-23(a) of the General Statutes of North Carolina, the undersigned nonprofit corporation does hereby submit the following for the purpose of designating its principal office address. 1. The name of the corporation is: 2. (Check only if applicable.) The street address of the principal office is not currently on file with the Secretary of State. 3. (Check only if applicable.) The mailing address of the principal office is not currently on file with the Secretary of State. 4. The street address and county of the designated principal office of the corporation is: Number and Street: City, State, Zip Code: County: 5. The mailing address if different from the street address of the designated principal office is: Number and Street: City, State, Zip Code: County: 6. This designation will be effective upon filing, unless a later date and/or time is specified: This the day of , 20. Name of Corporation Signature Type or Print Name and Title NOTES: 1. Filing fee is $5. This designation must be filed with the Secretary of State. American LegalNet, Inc. www.FormsWorkFlow.com