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APPLICATION FOR RENEWAL OF REGISTRATION OF FOREIGN L.L.C. NAME
Corporate Filings 312 Rosa L. Parks Avenue 6th Floor, William R. Snodgrass Tower Nashville, TN 37243 To the Secretary of State of the State of Tennessee: Pursuant to the provisions of §48-207-103(d) of the Tennessee Limited Liability Company Act or §48-249108(d) of the Tennessee Revised Limited Liability Company Act, the undersigned limited liability company hereby applies for renewal of the registration of its limited liability company name or assumed limited liability company name to and including December 31, and submits the following statement: 1. The name of the Limited Liability Company is:

If different, the name to be registered in the State of Tennessee is:

NOTE: The name must be distinguishable upon the records of the Secretary of State under §48-207-101(b) of the Tennessee Revised Limited Liability Company Act or §48-249-106(b) of the Tennessee Revised Limited Liability Company Act, as applicable. 2. The state or country of the organization is:

3. [Optional] The date of organization is 4. The nature of the business of the limited liability company is:

(month, day and year).

NOTE: This application must be accompanied by a certificate of existence (or document of similar import) duly authenticated by the Secretary of State or other official having custody of limited liability company records in the state or country under whose law it is organized. The certificate shall not bear a date of more than one (1) month prior to the date the application is filed in this state.

Mailing address line 1

Name of Limited Liability Company

Mailing address line 2

Signature

Date

City/State/Zip Code
SS-4237 (Rev. 09/06)

Name (typed or printed) and Signer's Capacity (if other than individual capacity)
Filing Fee $20 RDA 2458