Free STATEMENT OF CANCELLATION OF NON-REISSUABLE SHARES - Illinois

FORM BCA 9.05 (rev. Dec. 2003) STATEMENT OF CANCELLATION OF NON-REISSUABLE SHARES Business Corporation Act Secretary of State Department of Business Services Springfield, IL 62756 217-782-6961 www.cyberdriveillinois.com Remit payment in the form of a check or money order payable to Secretary of State.

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____________________________________ File #_____________________________

Filing Fee: $5

Approved: ____________

-------- Submit in duplicate -------- Type or Print clearly in black ink -------- Do not write above this line --------

1. Corporate Name: ________________________________________________________________________________ 2. The Corporation has acquired and cancelled its own shares, and the Articles of Incorporation prohibit the re-issuance of such shares. 3. Number of shares cancelled and redemption or purchase price:
Class Series Par Value

____________

_____________

______________

______________

Number of Shares Cancelled

______________

Redemption or Purchase Price

______________

Date of Cancellation

BEFORE CANCELLATION
Class Series Par Number Class

AFTER CANCELLATION
Series Par Number

4. Number of authorized shares: 5. Number of issued shares: 6. Paid-in capital: $_________________________ $_________________________

7. The undersigned Corporation has caused this statement to be signed by a duly authorized officer who affirms, under penalties of perjury, that the facts stated herein are true and correct. All signatures must be in BLACK INK. Dated _______________________________ , _____
Month & Day Any Authorized Officer's Signature Year

________________________________________________
Exact Name of Corporation

______________________________________ ______________________________________
Name and Title (type or print)

NOTE: This fo rm is applicable only where the Articles of Incorporation provide that shares redeemed or purchased shall be cancelled and shall not be re-issued. Upon such redemption and cancellation of shares, the paid-in capital of the Corporation is deemed to be reduced by that part of the paid-in capital which was represented by the shares so cancelled. The filing of this statement operates as an amendment to the Articles of Incorporation and reduces the number of shares of the class so redeemed which the Corporation is authori zed to issue by the number of shares so redeemed and cancelled.
Printed by authority of the State of Illinois. June 2006 - 1M - C 150.11