The undersigned hereby resigns the agency appointment as registered agent of [CORPORATION'S NAME].

1. The date of incorporation of the Corporation:

2. The name of the Corporation:

3. The name of the registered agent:

4. Street address of the registered agent:

5. This resignation will be effective upon filing. [IF STATE LAW PERMITS AN EFFECTIVE DATE LATER THAN THE DATE ON WHICH THE DOCUMENT IS FILED, SPECIFY ALTERNATIVE EFFECTIVE DATE, IF DESIRED.]

6. The registered office (is)(is not) also being discontinued.

Date:

_______________________________________________

Registered Agent's Signature [INCLUDE TITLE IF

SIGNING FOR CORPORATE REGISTERED AGENT]