CERTIFICATE OF FORMATION OF _____________________________ I, the below signed authorized person adopt the following certificate of formation: 1. The name of this limited liability company is: 2. The period of this limited liability company, unless sooner dissolved, is: 3. The name of the registered agent for this limited liability company is: with an address in this state at: Dated this ___ day of _________, 199___. _______________________________ Authorized signer