Customer Order Instructions

*230303* ROSS MILLER Secretary of State 202 North Carson Street Carson City, Nevada 89701-4201 (775) 684-5708 Website: www.nvsos.gov SUBMIT THIS COMPLETED FORM WITH YOUR FILING *230303* Customer Order Instructions USE BLACK INK ONLY - DO NOT HIGHLIGHT Processing Service Requested: Name of Entity: Regular 24-Hour Expedite (additional fee included) Date: Return to: Contact Name: Return Delivery: Email to: Hold for Pick Up Other: (explain below) Mail to Address Above Phone: (email or fax options do not receive a copy via mail; must be ordered separately) Fax to: FedEx: Acct # Order Description: (include items being ordered and fee breakdown)* *PLEASE NOTE: this office keeps the original paperwork. The first file stamped copy ordered at the time of filing is at no charge. Each additional copy is $2.00 per page (plus $30.00 for each certification). Total Amount: Method of Payment: Check/Money Order Credit Card (attach ePayment checklist) Trust Account: Use balance remaining in job # Nevada Secretary of State Customer Order Instructions Revised: 1-11-11 American LegalNet, Inc. www.FormsWorkFlow.com