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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 /> 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 /> 7.Name(s)and address(es)of the <br /> individual(s)causing the document <br /> to be delivered for filing: Brennan Stephanie L. <br /> (Last) (First) (Middle) (Suffix) <br /> 4860 Riverbend Road <br /> (Street name and number or Post Office Box information) <br /> Boulder CO 80301 <br /> (City) (State) (Postal/Zip Code) <br /> United States <br /> (Province—if applicable) (Country—if not US) <br /> (The document need not state the true name and address of more than one individual. However,if you wish to state the name and address <br /> of any additional individuals causing the document to be delivered for filing,mark this box ❑ and include an attachment stating the <br /> name and address of such individuals.) <br /> Disclaimer: <br /> This form,and any related instructions,are not intended to provide legal,business or tax advice,and are <br /> offered as a public service without representation or warranty. While this form is believed to satisfy minimum <br /> legal requirements as of its revision date,compliance with applicable law,as the same may be amended from <br /> time to time,remains the responsibility of the user of this form. Questions should be addressed to the user's <br /> attorney. <br /> REPORT Page 2 of 2 Rev.12/01/2012 <br />