Free Request for Certificate of Existence/Authorization - Tennessee

For Office Use Only

Corporate Certifications 312 Eighth Avenue North 6th Floor, William R. Snodgrass Tower Nashville, TN 37243

REQUEST FOR CERTIFICATE OF EXISTENCE/AUTHORIZATION (GOOD STANDING)

The below named applicant hereby applies for a Certificate of Existence/Authorization for the below listed corporation/limited liability company/limited partnership/limited liability partnership. 1. Exact name of the business:

State or country of incorporation/formation, if known: Secretary of State control number, if known: 2. If more than one certification is requested, please indicate the number: 3. The name and mailing address of the party to receive this order: Name ____________________________________________________ Address _________________________________________________ __________________________________________________________ City ______________________________________________________ State ____________________________ Zip Code _______________ NOTE: If the service of an "overnight"courier is to be utilized, a complete airbill (including the account number to which the charges for service should be made) must accompany this request.

4. This request must be accompanied by the statutory fee of $20.00 per certification per business. No credit will be extended. Make checks payable to: Tennessee Secretary of State. We regret that no requests can be taken by telephone, e-mail, or fax.

SS-4238(Rev. 5/00)

RDA 1678