Fill and Sign the Registered Agents and Service of Oregon Secretary of State Form

Application for Authority to Transact Bu siness - Business/ Profes sion al Secretar y of State - Corporation Divi sion - 255 Cap itol St. NE, Suite 151 - Sal em, OR 97310-1 327 – so s.or egon. gov/ b usine ss - Phone: (5 03) 986-2200 Ch eck the appr opriate box be low: FO REI GN BUSINESS C ORPORATION (Com plete on ly 1, 2 , 3, 4, 5, 6, 7, 8, 9, 11) FOREI GN PROFES SIONAL C ORPORATI ON (Com plete all items) RE GI STR Y NUM B ER : For office use onl y In acco rdance with Ore gon Revised S tatute 192. 410-192.490, the inf orma tion on th is application is pu blic re cord. W e must release th is inf orma tion to all par ties u pon request and it w ill be posted on our website. For office use onl y Pl ease Type or Print L egibly in Black Ink. A ttach A dditional S heet if Necess ary. 1) NAME OF COR POR AT ION : NO TE: Must be id entical to the name of recor d in home jurisdiction. 2) REGISTR Y NUM BER IN HOME JURIS DICTI ON 8) ADD R ESS F OR MAILING NOTICES : O R: C ERTIFIC ATE OF EXISTE NCE (ATTACHED ) (Pl ease p rovide a web -ve rifiable registry number fr om the en tity ’s hom e j ur isdiction . Certain sta tes, such as Del aware and Ne w Jersey, do not provid e status inf orma tion online. Entities f rom such places must in stead attach a n official certificate of ex istence, current within 60 da ys of de livery to this office.) 3) DATE OF INC ORPOR AT ION : DUR ATI ON , IF NOT PERPE TU AL : 9) NAM E AND ADDRESS OF PR ESID ENT AND SECR ETA RY : Pr es ident: 4) STATE OR COUNTR Y OF ORGANIZAT ION : Add ress: 5) ADDR ESS OF PRINCIP AL OFFI CE OF T HE BUSIN ESS : (Address, cit y, st at e, zip ) Secretary: Address: 6) NAME OF ORE GON REGIS TERED AGENT : 7) RE GISTERED AG EN T 'S PUBLICLY AV AILABLE ADD RESS : (Must b e an Oregon Street Address which is id enti cal to the regist er ed a gent’s business o ffice.) PROFESSI ONAL CORP OR ATION ONLY 10) PROFESS ION AL /BUSINESS SERVIC ES : (List pro fessional ser vice(s) and other business services, if app licable, to be r ender ed.) 11) EXECUTIO N : (Must be signed b y at l east one o ffice r or direct or.) I declare as an authorized signer, under penal ty of perjury, t hat this document does not frau dulently conceal, fraudul ently ob scure, fr aud ulently alte r or ot herw ise misr epresent the identi ty of the person o r an y officers, directors, emp loyees o r agents of the corporat ion. T hi s fi ling has b een examine d by me and is, to the best of my knowledge and be lief tr ue, correc t, and co mplete. Making false stateme nts in this docu ment is against th e law and may be pe nalized by fines, imprison ment o r both. Si gnature: Printed Name: Title: CONTACT NAME : (To resolve questi ons with th is fili ng.) FEES Require d Processing Fee $ 275 PHONE NUMBER : (Please include area co de.) Process ing Fees are n onrefundab le. Pl ease make check payable to “Co rp oration Division. ” Fr ee c opies are available at sos.or eg on.gov/bus iness , using the Busi ness Name Searc h program. 50 - App lication for Authority to Tr ansact Busi ness - Business Profe ssiona l (11/ 17)