Arkansas Secretary                                         of State        
                                                         1401 W.Capitol,  Suite 250,   Little Rock, AR 72201
                                                         501-682-3409 • www.sos.arkansas.gov
             M        ark                      Martin   

             Certificate of Withdrawal of Foreign Corporation

The undersigned, pursuant to Act 958 of 1987 and Arkansas Code Annotated § 4-27-1520, sets forth the following:
                                                         
1. Corporation Name:

2. State of Incorporation:

3. The Corporation is not transacting business in this State and hereby surrenders its authority to do so.

4. The Corporation revokes the authority of its registered agent to accept service of process on its behalf and appoints
   the Secretary of State 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 this State.

5. The corporation mailing address for any process served under above paragraph 4 is:

   Name:

   Address:

   City, State, & ZIP:

   Phone:

The Secretary of State shall be notified of any change of address of this corporation. 

Signed this                                     day of                     ,                              .

I understand that knowingly signing a false document with the intent to file with the Arkansas Secretary of State
is a Class C misdemeanor and is punishable by a fine up to $100.00 and/or imprisonment up to 30 days.

Authorizing Officer and Title (Type or Print)            Authorized signature and title

Fee: $300.00 payable to Arkansas Secretary of State                                           F-13/Rev. 07/15