Appointment of Statutory Agent - Business

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" rowspan="2" width=299 style="border-right: 1px solid #990000;" BGCOLOR="#C0C0C0" TEXT="#080000"> <bR> <div> <IMG BORDER="0" SRC="1x1.gif" HEIGHT="17" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="17"><FONT SIZE="2" COLOR="#000000" FACE="Arial" >                   </FONT><IMG BORDER="0" SRC="1x1.gif" HEIGHT="17" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="17"></div> <div> <A HREF="index.htm" TARGET="_top" TITLE="Casler Law Office"><B>HOME</B></A></div> <bR> <div> <A HREF="id2.htm" TARGET="_top" TITLE="About Carlton C. Casler"><B>About Carlton C. 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Casler"><B>Carlton C. Casler</B></A><B>, of the Casler Law Office, PLLC, </B><B>14140 West McDowell Road, Suite B-101, Goodyear, Arizona  85395</B><B>; phone number (602) 255-0101.</B></div> <bR> <div> Complete name of business (i.e., ABC, Incorporated):     </div> <input type="text" name="textfield" size="75"> <div> Principal place of business (i.e., city and state):     </div> <input type="text" name="textfield2" size="75"> <div> Business address (street, city, state, zip):     </div> <input type="text" name="textfield2" size="75"> <div> Telephone number:     </div> <input type="text" name="textfield2" size="75"> <div> E-Mail address:     </div> <input type="text" name="textfield2" size="75"> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> ______________________________________________________________</div> <div> Name (print)                         Signature                             Title                         Date</div> <div> <B> <img src="HTMLobj-21/aniGif.gif" border="0" align="bottom" width="133" height="100">  </B></div> <div> <B>Don't forget to sign the Appointment of Statutory Agent form.</B></div> <bR> <div> <B>FEE SCHEDULE:</B> The fee is only $55.00 per year and renewed automatically each year until canceled, plus $5.00 for each notice received and forwarded (if any) and $10.00 for each court document received and forwarded (if any). Copying charges, long distance telephone charges, postage and other expenses will be periodically billed to the owner's account.  Send $55.00 (check or charge authorization, below) for the first year.</div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B>MAIL to:</B> Casler Law Office, 14140 West McDowell Road, Suite B-101, Goodyear, Arizona  85395</div> <div> or </div> <div> <B>FAX to:</B> (602) 255-0431</div> <div> (only when paying by credit card; fax form above and "Charge Authorization" below)</div> <bR> <div> <B>TO PRINT THESE FORMS</B>: right click your mouse and select print; or from the menu bar, click on File/Print; or click the print icon on your menu bar.  <B>Because a signature is required to authorize the appointment of a statutory agent, this form cannot be submitted online.</B></div> <bR> <head><title>Untitled Document</title><meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"></head><form method="post" action="" name="casler"> <h4> <bR> <center>CHARGE AUTHORIZATION <div> ____________________________________________________________________________________</div> <div> I authorize a $55.00 charge to the following charge card:   </div> <bR> <input type="radio" name="Chargecard" value="radiobutton">MasterCard <input type="radio" name="Chargecard" value="radiobutton">Visa <input type="radio" name="Chargecard" value="radiobutton">Discover <input type="radio" name="Chargecard" value="radiobutton">American Express <div> Print name as it appears on credit card</div> <input type="text" name="textfield8" size="50"> <div> Account Number:     </div> <input type="text" name="textfield8" size="50"> <div> Expiration Date:     </div> <input type="text" name="textfield82" size="10"> <bR> <div> Signature: ________________________________________________________  Date: __________________________  </div> <div> ________________________________________________________________________________________________</div> <div>  (end of charge authorization) </div> </form> <DIV ALIGN="LEFT"></DIV> <div> <B> <img src="HTMLobj-22/aniGif.gif" border="0" align="bottom" width="133" height="100">  </B></div> <bR> <div> <B>Don't forget to sign your charge authorization.</B></div> <bR> <bR> <bR> <bR> <div> <A HREF="index.htm" TARGET="_top" TITLE="Casler Law Office"> <img src="HTMLobj-81/aniGif.gif" border="0" align="bottom" width="80" height="80">  </A></div> <bR> </td> </tr><tr> <td valign="top" colspan=2 height=109 style=" border-top: 1px solid #990000;" BGCOLOR="#FFFFFF" TEXT="#080000"> <div>            </div> <DIV ALIGN="LEFT"></DIV> <div> <B>Casler Law Office, PLLC</B></div> <div> <B>602-255-0101</B></div> <bR> </td> </tr></table></body>