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REGISTRY NUMBER - Oregon

Corporation/Limited Liability Company - Information Change Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 - - Phone: (503) 986-2200. Please Type or Print Legibly in Black ink. Attach Additional Sheet if Necessary. Fax: (503) 378-4381. Print Form REGISTRY NUMBER : ENTITY TYPE: DOMESTIC FOREIGN Reset Form In accordance with Oregon Revised Statute , the information on this application is public record. We must release this information to all parties upon request and it will be posted on our website. For office use only 1. NAME OF CORPORATION OR LIMITED LIABILITY COMPANY: Complete only the sections that you are updating. 2. business ACTIVITY 6. ADDRESS WHERE THE DIVISION MAY MAIL NOTICES: 3.

2. BUSINESS ACTIVITY 9. INDIVIDUAL WITH DIRECT KNOWLEDGE (Names and Addresses) List the name and address of at least one individual who is a director, or controlling shareholder of the corporation (member or manager of the LLC) or an authorized representative with direct knowledge of the operations and business activities of the corporation or LLC.

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