STATE OF SOUTH CAROLINA SECRETARY OF STATE NOTICE OF CHANGE

STATE OF SOUTH CAROLINA SECRETARY OF STATE NOTICE OF CHANGE OF PRINCIPAL OFFICE FOR A NONPROFIT CORPORATION TYPE OR PRINT CLEARLY IN BLACK INK Pursuant to Section 33-31-505 of the 1976 South Carolina Code of Laws, as amended, the undersigned corporation submits the following information: 1. Name of Corporation whose principal office is changing: 2. The corporation is, check either box “a “ or “b”: a. [ ] A domestic corporation incorporated under the laws of South Carolina, Date Incorporated A foreign corporation incorporated under the laws of another state or jurisdiction but qualified to transact business in South Carolina, Date Qualified b. [ ] 3. Current street address (with zip code) of the corporation’s principal office: Street Address City County State Zip Code 4. Unless a delayed date is specified, this application shall be effective upon acceptance for filing by the Secretary of State (See Section 33-31-123(b) of the 1976 South Carolina Code of Laws, as amended: Former street address (with zip code) of the corporation’s principal office Street Address 5. City County State Zip Code Date______________________ ______________________________________ Signature of Officer ______________________________________ Type or Print Name & Office FILING INSTRUCTIONS 1. 2. 3. 4. Two copies of this form, the original and either a duplicate original or a conformed copy, must be filed. The form must be filed within 30 days of the change in principal office. The form must be executed by an officer of the corporation or other person who performs the functions of an officer. If space in this form is insufficient, please attach additional sheets containing a reference to the appropriate paragraph in this form, or prepare this a computer disk, which will allow for expansion of space on this form. This form must be accompanied by the filing fee of $10.00 payable to the Secretary of State. 5. Return to: Secretary of State P.O. Box 11350 Columbia, SC 29211 NP-NOTICE OF CHANGE OF A PRINCIPAL OFFICE FOR A NP.doc Form revised by South Carolina Secretary of State, January 2000

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