Form Si-200 N/c - Statement Of Information (Domestic Stock Corporation) - 2006

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State of California

Secretary of State

STATEMENT OF INFORMATION

(Domestic Stock Corporation)

FEES (Filing and Disclosure): $25.00. If amendment, see instructions.

IMPORTANT — READ INSTRUCTIONS BEFORE COMPLETING THIS FORM

CORPORATE NAME

(Please do not alter if name is preprinted.)

This Space For Filing Use Only

DUE DATE:

[For forms preprinted by the Secretary of State.]

CALIFORNIA CORPORATE DISCLOSURE ACT

section 1502.1

)

(Corporations Code

SI-PT) annually, within 150 days

A publicly traded corporation must file with the Secretary of State a Corporate Disclosure Statement

(Form

after the end of its fiscal year. Please see reverse for additional information regarding publicly traded corporations.

NO CHANGE STATEMENT

If there has been no change in any of the information contained in the last Statement of Information filed with the Secretary of State, check

the box and proceed to Item 15.

If there have been any changes to the information contained in the last Statement of Information filed with the Secretary of State, or no

statement has been previously filed, this form must be completed in its entirety.

COMPLETE ADDRESSES FOR THE FOLLOWING

(Do not abbreviate the name of the city. Items 3 and 4 cannot be P.O. Boxes.)

STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE

CITY AND STATE

ZIP CODE

STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY

CITY

STATE

ZIP CODE

NAMES AND COMPLETE ADDRESSES OF THE FOLLOWING OFFICERS

(The corporation must have these three officers. A comparable title

for the specific officer may be added; however, the preprinted titles on this form must not be altered.)

CHIEF EXECUTIVE OFFICER/

ADDRESS

CITY AND STATE

ZIP CODE

SECRETARY/

ADDRESS

CITY AND STATE

ZIP CODE

CHIEF FINANCIAL OFFICER/

ADDRESS

CITY AND STATE

ZIP CODE

NAMES AND COMPLETE ADDRESSES OF ALL DIRECTORS, INCLUDING DIRECTORS WHO ARE ALSO OFFICERS

(The corporation

must have at least one director. Attach additional pages, if necessary.)

NAME

ADDRESS

CITY AND STATE

ZIP CODE

NAME

ADDRESS

CITY AND STATE

ZIP CODE

10. NAME

ADDRESS

CITY AND STATE

ZIP CODE

11. NUMBER OF VACANCIES ON THE BOARD OF DIRECTORS, IF ANY:

AGENT FOR SERVICE OF PROCESS (

If the agent is an individual, the agent must reside in California and Item 13 must be completed with a California

address. If the agent is another corporation, the agent must have on file with the California Secretary of State a certificate pursuant to Corporations Code

section 1505

and Item 13 must be left blank.)

12. NAME OF AGENT FOR SERVICE OF PROCESS

13. ADDRESS OF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN INDIVIDUAL

CITY

STATE

ZIP CODE

TYPE OF BUSINESS

14. DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION

15. BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE SECRETARY OF STATE, THE CORPORATION CERTIFIES THE INFORMATION CONTAINED HEREIN,

INCLUDING ANY ATTACHMENTS, IS TRUE AND CORRECT.

TYPE OR PRINT NAME OF PERSON COMPLETING THE FORM