Application for Amendment/Withdrawal - Foreign Business/Professional 
                      Secretaryof State -Corporation Division- 255 Capitol St. NE, Suite 151 - Salem, OR97310-1327– sos.oregon.gov/business - Phone: (503) 986-2200 
                      Check the appropriate box below: 
                           AMENDMENT TO APPLICATION FOR AUTHORITY                                                                                            Print Form
                      (Complete only 1, 2, 8) 
                           WITHDRAWAL OF AUTHORITY TO TRANSACT 
                                                                                                                                                             Reset Form
                      (Complete only 3, 4, 5, 6, 7, 8) 
REGISTRY   NUMBER     : 
In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record. 
W e must release this information to all parties upon request and it will be posted on our website.                                                          For office use only 
Please Type or Print Legibly in Black Ink.  Attach Additional Sheet if Necessary. 
                                                                   AMENDMENT TO        APPLICATION O  NLY

 1)  ENTITY NAME :
2) AMENDMENT        : (The amendment is as follows.)

                                                       WITHDRAWAL OF AUTHORITY TO TRANSACT BUSINESS ONLY

3)  NAME  :
4) STATE   OR COUNTRY            OFINCORPORATION      :
5) THISC  ORPORATION IS NOT TRANSACTING                BUSINESSINOREGON,ANDSURRENDERSITS AUTHORITY TOTRANSACT                                  BUSINESSIN OREGON.
6) THIS C ORPORATION REVOKES         THE AUTHORITY OF ITS REGISTERED AGENT TO ACCEPT SERVICE 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 TRANS ACT BUSINESS IN OREGON.
7) MAILINGADDRESS           :(The address to which the person initiating anyproceeding maymail to thisCorporation acopy     of any process served on the  Secretaryof State. The
   Corporation will notify the Corporation Division, Business Registry of any change in this mailing address for a period of five years from the date of this withdrawal.)

8) EXECUTION: (Must be signed by at least one officer or director.)
   I declare as an authorized signer, under penalty of perjury, that this document does not fraudulently conceal, fraudulently obscure,
   fraudulently alter or otherwise misrepresent the identity of the person or any officers, directors, employees or agents of the corporation.
   This filing has been examined by me and is, to the best of my knowledge and belief true, correct, and complete. Making false
   statements in this document
   is against the law and may be penalized by fines, imprisonment or both.
   Signature:                                                            Printed Name:                                             Title:

CONTACT NAME       :(To resolve questions with this filing.)                              FEES 
                                                                                          Required Processing Fee      $275 
PHONE N  UMBER     : (Include area code.)                                                 Processing Fees are nonrefundable.    Please make check payable to “Corporation Division.” 
                                                                                          Free copies are available at   sos.or egon.gov/ bus iness, using the Business Name Search program. 

 51 -ApplicationforAmendment       W ithdrawal - ForeignBusiness Professional(11/17)