Free Affidavit - Tennessee

For Office Use Only

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

THIS IS TO CERTIFY UNDER THE PENALTIES OF PERJURY THAT

IS A CHURCH AND THE INTERNAL REVENUE SERVICE CONTINUES TO HONOR ITS CLAIM TO AN AUTOMATIC EXEMPTION FROM PAYMENT OF FEDERAL INCOME TAX UNDER ¶501(C)(3) OF THE INTERNAL REVENUE CODE (26 U.S.C., ¶501(C)(3)). I FURTHER CERTIFY THAT THE AFORESAID CORPORATION IS EXEMPT AND IS CURRENTLY OPERATING UNDER SAID EXEMPTION, AND I KNOW OF NO VIOLATIONS OF FEDERAL STATUTES AND RULES AND REGULATIONS OF FEDERAL DEPARTMENTS INCLUDING THE

INTERNAL REVENUE SERVICE WHICH WOULD JEOPARDIZE THIS EXEMPTION. THIS AFFIDAVIT IS
SUBMITTED IN LIEU OF PROVIDING THE NAMES AND ADDRESSES OF THE PRINCIPAL OFFICERS AND BOARD OF DIRECTORS OF THIS CORPORATION ON THE ANNUAL REPORT REQUIRED BY TENNESSEE

CODE ANNOTATED SECTION 48-66-203.

SIGNATURE OF PRESIDENT OR OTHER PRINCIPAL OFFICER OF THE CORPORATION

STATE OF
DATE

COUNTY OF SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF ,

NOTARY PUBLIC

D ATE

C OMMISSION

E XPIRES

SS-4459 (Rev.11/99) RDA 1678