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

     FORM MUST BE TYPED            Foreign Certifi cate of Withdrawal                                                                                                                      FORM MUST BE TYPED
                        (General Laws Chapter 156D, Section 15.20; 950 CMR 113.51)

     (1)  Exact name of corporation: ___________________________________________________________________________

     (2)  Jurisdiction of incorporation: __________________________________________________________________________

      Date of incorporation:   ______________________________________________________________________________
                                                                                                                                           (month, day, year)

     (3)  Th  e corporation is not transacting business in the commonwealth.

     (4)  Th  e corporation surrenders its authority to transact business in the commonwealth.

     (5)  Th  e corporation revokes the authority of its registered agent to accept service on its behalf.

     (6)  Th  e Secretary of the Commonwealth is hereby appointed as its agent for service of process in any proceeding based on a cause 
      of action arising during the time it was authorized to transact business in the commonwealth.

     (7)  Th  e corporation’s mailing address to which the Division may mail a copy of any process served on it:

        ________________________________________________________________________________________________
                                                                                                                                           (number, street, city or town, state, zip code)

     (8)  Th  e corporation shall notify the Division in the future of any changes to the above mailing address by fi ling a certifi cate of 
      amendment.

     (9)  Th  e corporation hereby certifi es that all taxes known to the corporation to be due the commonwealth have been paid or pro-
      vided for.

     (10)Th  is certifi cate is eff ective at the time and on the date approved by the Division, unless a later eff ective date not more than 90 
      days from the date of fi ling is specifi ed:  __________________________________________________________________

     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.                                                                                                                                                                                      c156ds1520950c11351 01/13/05

         COMMONWEALTH OF MASSACHUSETTS

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

         Foreign Certifi cate of Withdrawal
          (General Laws Chapter 156D, Section 15.20; 950 CMR 113.51)

        I hereby certify that upon examination of this foreign certifi cate withdrawal, duly 
        submitted to me, it appears that the provisions of the General Laws relative thereto 
        have been complied with, and I hereby approve said certifi cate; and the fi ling fee in 
        the amount of $ ___________________________________________________
        having been paid, said certifi cate 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: $100

Examiner
         TO BE FILLED IN BY CORPORATION
                                                                       Contact Information:
#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.