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COMMONWEALTH OF VIRGINIA

STATE CORPORATION COMMISSION

BTA1242

APPLICATION FOR A CERTIFICATE OF REGISTRATION

(04/09)

TO TRANSACT BUSINESS IN VIRGINIA AS A FOREIGN BUSINESS TRUST

1. The name of the foreign business trust is (include, if required, any “for use in Virginia” name in parentheses)

______________________________________________________________________________

______________________________________________________________________________.

2. The foreign business trust was formed under the laws of

___________________________________________ on ______________________________.

(state or other jurisdiction of formation)

(date of business trust’s formation)

3. (Mark if applicable:)

The business trust was previously authorized or registered with the

Commission to transact business in Virginia as a foreign business entity. (See instructions.)

Set forth

the additional required information on an attachment.

4. A. The name of the business trust’s registered agent in VIRGINIA is

___________________________________________________________________________.

B. The registered agent is (mark appropriate box):

(1) an INDIVIDUAL who is a resident of Virginia and

a trustee or officer of the business trust

an officer or director of a corporation that is a trustee of the business trust

a general partner of a general or limited partnership that is a trustee of the business trust

a member or manager of a limited liability company that is a trustee of the business trust

a trustee of a business trust or other trust that is a trustee of the business trust

a member of the Virginia State Bar

(2)

a domestic or foreign stock or nonstock corporation, limited liability company, registered

limited liability partnership or business trust authorized to transact business in Virginia.

C. The business trust’s VIRGINIA registered office address, including the street and number, if

any, which is identical to the business office of the registered agent, is

_____________________________________________________________, VA __________,

(number/street)

(city or town)

(zip)

which is physically located in the

county or

city of _______________________________.

5. The Clerk of the Commission is irrevocably appointed as the agent of the foreign business trust for service

of process if the business trust fails to maintain a registered agent in Virginia as required by § 13.1-1220 of

the Code of Virginia, the registered agent's authority has been revoked, the registered agent either has

resigned, or the registered agent cannot be found or served with the exercise of reasonable diligence.

6. The post office address, including the street and number, if any, of the foreign business trust’s principal office is

______________________________________________________________________________.

(number/street)

(city or town)

(state)

(zip)

7. The foreign business trust is a “foreign business trust” as defined in § 13.1-1201 of the Code of Virginia.

Executed in the name of the foreign business trust by:

_________________________________

________________

_______________________

(signature)

(date)

(telephone number (optional))

_________________________________

______________________________________________

(printed name)

(title (e.g., trustee or title of officer)) (see instructions for requisite signature)

PRIVACY ADVISORY: Information such as social security number, date of birth, maiden name, or financial institution account numbers is NOT required to be included

in business entity documents filed with the Office of the Clerk of the Commission. Any information provided on these documents is subject to public viewing.

SEE INSTRUCTIONS ON THE REVERSE