Written Consent Form: Washington, DC

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WRITTEN CONSENT TO ACT AS REGISTERED AGENT PURSUANT TO D.C.CODE TITLE 29 AND TITLE 4 TO: DEPARTMENT OF CONSUMER AND REGULATORY AFFAIRS ONE STOP BUSINESS CENTER 941 NORTH CAPITOL STREET, N.E., ROOM #1100 WASHINGTON, D.C. 20002 THE CORPORATION HEREIN NAMED IS: COMPANY NAME INC. An Authorized Corporate Registered Agent in the District of Columbia, per signature of its President Herein Consents to Act as Registered Agent For: COMPANY NAME INC. SIGNATURE: ___________________________ [Name], President DATE [Date]

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