Free Application for Renewal of Registration of Assumed Corporation Name - Tennessee

ISSUANCE DATE: CONTROL NUMBER:
Corporate Filings 312 Eighth Avenue North 6th Floor, William R. Snodgrass Tower Nashville, TN 37243

Assumed Name: Date of Expiration: RE: EXPIRATION OF REGISTRATION OF ASSUMED CORPORATE NAME Pursuant to the provisions of Section 48-14-101(3) of the Tennessee Business Corporation Act or Section 48-54-101(3) of the Tennessee Nonprofit Corporation Act, it has been determined that the registration of the assumed corporate name will expire in three (3) months. You may renew the assumed name by completing an application for renewal of assumed corporate name within two (2) months preceding the expiration and paying the $20 renewal filing fee. Failure to file the required document within the two (2) months preceding the expiration of the registration of the assumed corporate name will result in expiration of the assumed name. APPLlCATION FOR RENEWAL OF REGISTRATION OF ASSUMED CORPORATE NAME Pursuant to the provisions of Section 48-14-101(4) of the Tennessee Business Corporation Act or Section 48-54-101(4) of the Tennessee Nonprofit Corporation Act, the undersigned corporation hereby submits this application for renewal: 1. The true name of the corporation is:

2. The state or country of incorporation is: 3. The corporation intends to transact business in Tennessee under an assumed corporate name. 4. The assumed corporate name the corporation proposes to use is:

[NOTE: The assumed corporate name must meet the requirements of Section 48-14-101 of the Tennessee Business Corporation Act or Section 48-54-101 of the Tennessee Nonprofit Corporation Act.]

Signature Date Signer's Capacity

Name of Corporation Signature Name (typed or printed)

SS-4481 (Rev.6/00)

RDA 1678