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Docketing Statement Changes DSCB 15-134B BUREAU USE ONLY Revenue Labor Industry Other File Code Filed Date Part I. Complete for each filing Current name of entity or registrant survivor or new entity if merger or consolidation Entity number if known State of Inc Incorporation/qualification date in PA Federal EIN Specified effective date if any Part II. Check proper box Amendment complete Section A Merger Consolidation or Division complete Section B C or D Consolidation complete Section C Division complete Section D Conversion complete Section A E Correction complete Section A Termination complete Section H Revival complete Section G Dissolution before Commencement of Business complete Section F Section A Check box es which pertain to changes Name Registered Office Number street/RD number box number City State Zip County Purpose Stock aggregate number of share authorized Effective date Term of Existence Other. Section B Merger Complete Section A if any changes to surviving entity Merging Entities are attach sheet for additional merging entities Entity if known Inc*/qual* date in PA. Section C - Consolidation Consolidating Entities are attach sheet for additional consolidating entities Section D Division Forming new entity s named below attached sheet for additional entities Check one Entity named in Part I survives. any changes complete Section A Section E Conversion complete Section A Converted from nonprofit to profit Section F Dissolved by Shareholders or Incorporators Before Commencement of Business Section G Statement of Revival complete Section A for any changes to revived entity filed in the Department of State on is/are hereby terminated* type of filing made month/date/year hour if any If merger consolidation or division list all entities involved other than that listed in Part I. Complete for each filing Current name of entity or registrant survivor or new entity if merger or consolidation Entity number if known State of Inc Incorporation/qualification date in PA Federal EIN Specified effective date if any Part II. Check proper box Amendment complete Section A Merger Consolidation or Division complete Section B C or D Consolidation complete Section C Division complete Section D Conversion complete Section A E Correction complete Section A Termination complete Section H Revival complete Section G Dissolution before Commencement of Business complete Section F Section A Check box es which pertain to changes Name Registered Office Number street/RD number box number City State Zip County Purpose Stock aggregate number of share authorized Effective date Term of Existence Other. Check proper box Amendment complete Section A Merger Consolidation or Division complete Section B C or D Consolidation complete Section C Division complete Section D Conversion complete Section A E Correction complete Section A Termination complete Section H Revival complete Section G Dissolution before Commencement of Business complete Section F Section A Check box es which pertain to changes Name Registered Office Number street/RD number box number City State Zip County Purpose Stock aggregate number of share authorized Effective date Term of Existence Other. Section B Merger Complete Section A if any changes to surviving entity Merging Entities are attach sheet for additional merging entities Entity if known Inc*/qual* date in PA. .

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