Commercial Registered Agent Listing Statement {56371}

INSTRUCTIONS: 1. Use 8275224 x 11224 white paper for attachments. 2. Please TYPE or PRINT in INK. 3. Please visit our office on the web at www.sos.IN.gov 4. Make check or money order payable to the Secretary of State. 5. Submit original completed paperwork and payment to: 302 West Washington Street, Room E-018, Indianapolis, IN 46204. NOTE: If the Commercial Registered Agent represents a large number of businesses, it is strongly recommended that you file this Commercial Registered Agent Listing Statement electronically. (SOS use only) (If different from above 226 SOS use only) American LegalNet, Inc. www.FormsWorkFlow.com (choose one) (Select this if the commercial registered agent is an individual or a general partnership.) (Select this if the commercial registered agent is an entity other than an individual or general partnership. Please note: the entity must be registered with the Secretary of State's Office.) The name of the commercial registered agent must be distinguishable on the records of the Secretary of State from the name of another commercial registered agent.) If the commercial registered agent is an entity: Provide an address of a place of business of the person in this state to which service of process being served on the represented entities may be delivered. American LegalNet, Inc. www.FormsWorkFlow.com Note: If the Commercial Registered Agent does not list all of the businesses represented by it on this Commercial Registered Agent Listing Statement, the Commercial Registered Agent or the individual represented business will be required to file a Statement of Change of Registered Agent. American LegalNet, Inc. www.FormsWorkFlow.com