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Salida CO 81201 <br /> (City) (State) (ZIP Code) <br /> (The following statement is adopted by marking the box.) <br /> ❑✓ The person appointed as registered agent has consented to being so appointed. <br /> 4. The true name and mailing address of the person forming the limited liability company are <br /> Name <br /> (if an individual) Tunstall Stephanie A. <br /> (Last) (First) (Middle) (Suffix) <br /> or <br /> (if an entity) <br /> (Caution: Do not provide both an individual and an entity name.) <br /> Mailing address 541 Cox Lane <br /> (Street number and name or Post OJice Box information) <br /> Howard CO 81233 <br /> (City) (State) (ZIP/Postal Code) <br /> United States <br /> (Province—if applicable) (Country) <br /> (If the following statement applies,adopt the statement by marking the box and include an attachment) <br /> ❑ The limited liability company has one or more additional persons forming the limited liability <br /> company and the name and mailing address of each such person are stated in an attachment. <br /> 5. The management of the limited liability company is vested in <br /> (Mark the applicable box.) <br /> ❑✓ one or more managers. <br /> or <br /> ❑the members. <br /> 6. (The following statement is adopted by marking the box.) <br /> ❑✓ There is at least one member of the limited liability company. <br /> 7. (If the following statement applies,adopt the statement by marking the box and include an attachment.) <br /> ❑ This document contains additional information as provided by law. <br /> 8. (Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has <br /> significant legal consequences. Read instructions before entering a date) <br /> (If the following statement applies,adopt the statement by entering a date and,if applicable,time using the required format.) <br /> The delayed effective date and, if applicable,time of this document is/are <br /> (mm,lddlyyyy hour.minute am/pm) <br /> Notice: <br /> Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or <br /> acknowledgment of each individual causing such delivery, under penalties of perjury,that the document is the <br /> individual's act and deed,or that the individual in good faith believes the document is the act and deed of the <br /> person on whose behalf the individual is causing the document to be delivered for filing,taken in conformity <br /> with the requirements of part 3 of article 90 of title 7, C.R.S.,the constituent documents, and the organic <br /> statutes,and that the individual in good faith believes the facts stated in the document are true and the <br /> document complies with the requirements of that Part,the constituent documents,and the organic statutes. <br /> ARTORG_LLC Page 2 of 3 Rev 12/01/2012 <br />