Certificate Form Of Conversion From A Delaware Or Non-Delaware Corporation To A Delaware Statutory Trust Form - 2005 Page 2

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STATE OF DELAWARE
CERTIFICATE OF CONVERSION
FROM A CORPORATION TO A
STATUTORY TRUST PURSUANT TO
SECTION 3820 OF THE DELAWARE
STATUTORY TRUST CODE
1.) The jurisdiction where the Corporation first formed is
___________________.
2.) The jurisdiction immediately prior to filing this Certificate is______________.
3.) The date the corporation first formed is_______________________________.
4.) The name of the Corporation immediately prior to filing this Certificate is
_______________________________________________________________.
5.) The name of the Statutory Trust as set forth in the Certificate of Trust is
_______________________________________________________________.
IN WITNESS WHEREOF, the undersigned have executed this Certificate on the
___________day of _________________, A.D._______________.
By:____________________________
Trustee(s)
Name:____________________________
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