Annual Statement

Print Form

Annual Statement For publication in compliance with Nevada Laws (see below). The following is the only financial information required. When completing the form below, please be sure the typing is sharp and signature fairly heavy and legible. Please type only within the spaces provided. Attach check for $34.95. Thank you.

Legal Notice Nevada Revised Statutes, Section 1. NRS 80.190 Publication of Annual Statements: 1. Except as otherwise provided in subsection 2, each foreign corporation doing business in this state shall, not later than the month of March in each year publish a statement of its last calendar year's business in two numbers or issues of a newspaper published in this state. 2.

If the corporation keeps its records on the basis of a fiscal year other than the calendar, the statement required by subsection 1 shall be published not later than the end of the third month following the close of each fiscal year.

Annual Statement Of The

For The Year Ending

Location of Principal Office

Location or locations of business in Nevada (INC., CO.) did/ or did not conduct business in the State of Nevada during the calendar year

I Name and Official Position

do hereby certify that the foregoing is a true and accurate statement of the business transacted by said corporation during

Attach check for $34.95 Sign and mail to: Carson City Nevada Appeal Annual Statement Dept. P.O. Box 2288 Carson City, N.V. 89702-2288 Phone (775) 881-1201 Fax (775) 887-2408

Date

Signature

NOTE: Please fill out space below if affidavit is to be mailed to a different address than above.

Date of signature