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4. The principal office address of the entity's principal office is <br />Street address 13000 County Road 2 <br />(Street number and name) <br />Maw address <br />(leave blank if same as street address) <br />Rangely CO 81648 <br />(City) (State) (Postal/Zip Code) <br />United States <br />(Province if applicable) (Country if not US) <br />(Street number and name or Post Office Box information) <br />(City) {Brute} (Postal/Zip Code) <br />(Province .. ifapplicable) (Country- if not US) <br />(l the following statement applies, adopt the statement by marking the box.) <br />DflThe mailing address in the records of the Secretary of State is no longer different than the street <br />address and is no longer required. <br />5. (If the fallowing statement applies, adopt the statement by marking the box and include an atraclunent.) <br />❑ This document contains additional information as provided by law. <br />6. (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 />(!f rhe following statement applies, adapt the statement by entering a dale and, ifapplicable, time using the required farmal.) <br />The delayed effective date and, if applicable, time of this document is/are <br />(rm Iddlyyyy houraninute arn/prn) <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 />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. The true name and mailing address of the individual causing the document to be delivered for filing are <br />Dunn Adam <br />(Iasi) (First) (Middle) (Suffix) <br />110 West Tabernacle <br />(Street number and name or Post Office Box information) <br />St. George UT 84770 <br />(City) (State) (PostallZp Code) <br />(Province -- if applicable) <br />(Country ifnot US) <br />CURE DLQ Page 2 of 3 Rev. 8/082412 <br />