Annual Report (Domestic Or Foreign Corporations)

ANNUAL REPORT ON DOMESTIC OR FOREIGN CORPORATIONS (DUE ON OR BEFORE JUNE 30TH OF EACH YEAR) PURSUANT TO SECTIONS 371 AND 373, CHAPTER 1, TITLE 13 OF THE VIRGIN ISLANDS CODE, REQUIRING THE FILING OF ANNUAL REPORTS BY DOMESTIC AND FOREIGN CORPORATIONS THE FOLLOWING STATEMENT IS FILED WITH THE OFFICE OF THE LIEUTENANT GOVERNOR. NAME OF CORPORATION ADDRESS OF MAIN OFFICE ...................................................................................................... ................................................................................................... ........................................................................... ....................................................................... ..................................................................... .................................................................. PRINCIPAL OFFICE IN THE VIRGIN ISLANDS RESIDENT OR AUTHORIZED AGENT IN THE V.I. COUNTRY OR STATE IN WHICH INCORPORATED FISCAL YEAR COVERED BY LAST REPORT FILED 1 FISCAL YEAR COVERED BY THIS REPORT 2 ............................................................................ .............................................. AMOUNT OF AUTHORIZED CAPITAL STOCK AT CLOSE OF FISCAL YEAR AMOUNT OF PAID-IN CAPITAL AT CLOSED OF FISCAL YEAR .................................................... AMOUNT OF CAPITAL USED IN CONDUCTING BUSINESS WITHIN THE VIRGIN ISLANDS DURING THE FISCAL YEAR ............................................................................................................... NAME AND ADDRESSES OF DIRECTORS AND OFFICERS OF THE COMPANY AT THE CLOSE OF FISCAL YEAR AND EXPIRATION DATES OF TERMS OF OFFICE: (Minimum of three different directors) ............................................................................................................................................. ............................................................................................................................................. ............................................................................................................................................. DATED: ......................... VERIFIED: ....................................................... (President) or (Vice President) CHECK BOX TO REQUEST CERTIFICATE OF GOOD STANDING PLEASE NOTE: THERE IS A $25.00 FEE ...................................................... (Treasurer) or (Asst. Treasurer) CONTACT NAME ................................................... .............................................. CONTACT NUMBER 1. If the last report filed does not cover the period immediately preceding the period covered by this report, a supplementary report on the same must be filed, bridging the gap between the two reports. THIS REPORT IS NEITHER COMPLETE NOR ACCEPTABLE UNLESS ACCOMPANIED BY A GENERAL BALANCE SHEET AND PROFIT AND LOSS STATEMENT FOR THE LAST FISCAL YEAR AS REQUIRED BY THE VIRGIN ISLANDS CODE. FINANCIAL STATEMENTS SHOULD BE SIGNED BY AND INDEPENDENT PUBLIC ACCOUNTANT. American LegalNet, Inc. www.FormsWorkflow.com 2.