Application For Registration Of Name

Foreignnameregistration Secretary of State Office 500 E Capitol Ave Pierre, SD 57501 (605)773-4845 1.The name of the corporation: 2.The name of the state or other jurisdiction under whose laws it is incorporated: 3.The date of its incorporation: 4.The business in which it is engaged: 5.This application is accompanied by an original Certificate of Existence executed by the Secretary ofState or other official having custody of the corporate records in the state or other jurisdiction under whose law itis incorporated. 6.This application does not qualify the corporation to conduct business in South Dakota. The registration is effective until the close of the calendar year in which the application for registration is filed. A renewal application may be filed between the first day of October and the thirty-first day of December each year, and shall extend the registration for the following calendar year. Application must be signed by an authorized officer of the corporation. No person may execute this report knowing it is false in any material respect. Any violation may be subject to a civil and/or criminal penalty (SDCL 47-1A-129; 22-39-36). Dated Signature of an authorized person Email (Optional) Printed Name Title APPLICATION FOR REGISTRATION OF NAME FOREIGN BUSINESS CORPORATION SDCL 47-1A-403 FILING FEE: $25 ayable to SECRETARY OF STATE American LegalNet, Inc. www.FormsWorkFlow.com