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This perjury notice applies to each individual who causes this document to be delivered to the Secretary of <br /> State,whether or not such individual is named in the document as one who has caused it to be delivered. <br /> 9. The true name and mailing address of the individual causing the document to be delivered for filing are <br /> Powell Greg <br /> (Last) (First) (Middle) (Suffix) <br /> PO Box 1380 <br /> (Street number and name or Post Office Box information) <br /> Salida CO 81201 <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 /> This document contains the true name and mailing address of one or more additional individuals <br /> causing the document to be delivered for filing. <br /> Disclaimer: <br /> This form/cover sheet, and any related instructions,are not intended to provide legal,business or tax advice, <br /> and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy <br /> minimum legal requirements as of its revision date,compliance with applicable law, as the same may be <br /> amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should <br /> be addressed to the user's legal, business or tax advisor(s). <br /> ARTORG_LLC Page 3 of 3 Rev. 12/01/2012 <br />