Free - West Virginia

Natalie E.Tennant Secretary of State State Capitol 1900 Kanawha Blvd. East Charleston, WV 25305 Hrs. 8:30 am - 5:00 pm

Fee: $15 per application FILE ONE ORIGINAL (Send two originals if you want a filed copy returned to you)

Penney Barker, Manager Business & Licensing Tel: (304)558-6000 Toll Free: (866)767-8683 Fax: (304) 558-8381 email: [email protected] web: www.wvsos.com

APPLICATION TO APPOINT OR CHANGE PROCESS, OFFICERS, MEMBERS, MANAGERS and/or OFFICE ADDRESSES

1. The company filing this change is registered as a:

Corporation Limited Liability Company Limited Liability Partnership

Limited Partnership Voluntary Association Business Trust

2. The change is filed for:
(Note: Enter information as previously filed. No change can be accepted without this information.)

Company name Principal Office Address As Listed Home State: WV Formation Date

Access current company record at www.wvsos.com

3. Change of Address (use appropriate lines for the type of address to be changed): Address Type a. Principal Office New Address

b. Local Office (WV)

c. Designated Office (LLC) (must be physical address)

Form AAO

SECRETARY OF STATE, STATE CAPITOL, CHARLESTON WV 25305

Revised 1/09

4. Change of Agent for Service of Process: The agent named here has given consent to appointment as agent to accept service of process on behalf of this company.

New Agent Name and Address

New Agent Signature

5. Complete the Change of Officers or Other Persons in Authority: Officer Type a.
(check one for each new officer.)

New Officer Name

New Officer Address

President (Corp. VA) Manager (LLC) General Partner (LP, LLP) Trustee (Bus. Trust) Remove (Previous officer name, if any.) Other Vice-President (Corp. VA) Manager (LLC) General Partner (LP, LLP) Trustee (Bus. Trust) Remove (Previous officer name, if any.) Other Secretary (Corp. VA) Member (LLC) Limited Partner (LP) General Partner ( LLP) Trustee (Bus. Trust) Other Treasurer (Corp. VA) Member (LLC) Limited Partner (LP) General Partner ( LLP) Trustee (Bus. Trust) Other Director (Corp. VA) Member (LLC) Limited Partner (LP) General Partner ( LLP) Trustee (Bus. Trust) Other
Name (please print)

b.

c.

Remove

(Previous officer name, if any.)

d.

Remove

(Previous officer name, if any.)

e.

Remove

(Previous officer name, if any.)

Title
RESET
SECRETARY OF STATE, STATE CAPITOL, CHARLESTON WV 25305

Signature
Revised 1/09

Form AAO