F             The Commonwealth of Massachusetts
                                                                                                                                           William Francis Galvin
                                            Secretary of the Commonwealth
FPC
                       One Ashburton Place, Room 1717, Boston, Massachusetts 02108-1512

     FORM MUST BE TYPED                                                                                                                    Foreign Application For             FORM MUST BE TYPED
                                                                                                                                           Transfer of Authority
                       (General Laws, Chapter 156D, Section 15.23; 950 CMR 113.53)

     (1)  Exact name of corporation: ___________________________________________________________________________

     (2)  Type of other entity into which the corporation has converted:  ________________________________________________

     (3)  Jurisdiction upon transfer of authority:  __________________________________________________________________

     (4)  Attach an additional sheet(s) containing all other information required in a fi ling under the laws of the commonwealth by an 
      other entity of the type the corporation has become seeking authority to transact business in the commonwealth.

     (5)  Th  is application is eff ective at the time and on the date approved by the Division, unless a later eff ective date is specifi ed in 
      accordance with the organic law of the surviving entity:  _____________________________________________________

     Attach  certifi cate of legal existence or a certifi cate of good standing issued by an offi  cer or agency properly authorized in the 
     jurisdiction of organization.  If the certifi cate is in a foreign language, a translation thereof under oath of the translator shall be 
     attached.

     Signed by:  ___________________________________________________________________________________________ ,
                                                                                                                                           (signature of authorized individual)
      ®  Chairman of the board of directors,
      ®  President,
      ®  Other offi  cer,
      ®  Court-appointed fi duciary,

     on this _________________________day of_________________________________________day of_________________________________________day of                                     ,  _____________________ .

P.C.                                                                                                                                                                           c156ds1523950c11353 07/19/05

               COMMONWEALTH OF MASSACHUSETTS

                                                                             William Francis Galvin
                                                                             Secretary of the Commonwealth
               One Ashburton Place, Boston, Massachusetts 02108-1512

               Foreign Application For 
                                                                             Transfer of Authority
               (General Laws, Chapter 156D, Section 15.23; 950 CMR 113.53)

              I hereby certify that upon examination of this foreign application for transfer of 
              authority, duly submitted to me, it appears that the provisions of the General Laws 
              relative thereto have been complied with, and I hereby approve said application; 
              and the fi ling fee in the amount of $  ___________________________________
              having been paid, said application is deemed to have been fi led with me this
              _____________ day of  _____________day of  _____________day of , 20______ , at _______a.m./p.m.
                                                                                                          time

              Eff ective date: _____________________________________________________
                                                                             (must be within 90 days of date submitted)

               WILLIAM FRANCIS GALVIN
                                                                             Secretary of the Commonwealth

                                                                             Filing fee: Minimum $250.00
Examiner

Name approval  TO BE FILLED IN BY CORPORATION
                                                                             Contact Information:

C
              ___________________________________________________________

M
              ___________________________________________________________

# A.R.
              ___________________________________________________________

              Telephone: ___________________________________________________

              Email:  ______________________________________________________

              Upon fi ling, a copy of this fi ling will be available at www.sec.state.ma.us/cor.
              If the document is rejected, a copy of the rejection sheet and rejected document will 
              be available in the rejected queue.