Notice Of Termination To Existing Service Area

BARBARA K. CEGAVSKE Secretary of State 202 North Carson Street Carson City, Nevada 89701-4201 (775) 684-5708 Website: www.nvsos.gov Notice of Termination to Existing Service Area (PURSUANT TO NRS CHAPTER 711) USE BLACK INK ONLY - DO NOT HIGHLIGHT ABOVE SPACE IS FOR OFFICE USE ONLY 1. Name of Certificate Holder: 2. The existing authorized service area designated to provide video service is being terminated as follows: (if additional space is needed, please attach an 8 1/2" x 11" plain sheet of paper and continue) 3. Signature of Certificate Holder: Name Title X Authorized Signature Filing Fee: $1,000.00 American LegalNet, Inc. www.FormsWorkFlow.com Nevada Secretary of State CA Terminate Revised:: 1-5-15