APPOINTMENT OF THE SECRETARY OF STATE



APPOINTMENT OF THE SECRETARY OF STATE

AS AGENT OF SERVICE

THE STATE OF ____________________ }

} KNOW ALL MEN BY THESE PRESENTS

COUNTY OF _______________________}

That________________________________________________________________, a

telephone solicitation seller in the state of ____________________, does hereby irrevocably designate, constitute and appoint the Secretary of State of the State of Texas and any successors in office, the authorized agent and attorney-in-fact of the above-named seller for the purpose of accepting service for it and being served for it with citation in any non-criminal suit, action, or proceeding against said seller or the seller's successor, executor, or administrator that may arise under Tex. Bus. & Com. Code, Section 302.001 et seq.

_________________________________ _____________________________________

(Signature & Title) (Signature & Title)

_________________________________ _____________________________________

(Typed or Printed Name) (Typed or Printed Name)

_________________________________ ____________________________________

(Signature & Title) (Signature & Title)

_________________________________ _____________________________________

(Typed or Printed Name) (Typed or Printed Name)

State of ______________________

County of ____________________

Sworn to and subscribed before me on the _______ day of ______________________, _______.

_____________________________________

Notary Public Signature

(seal)

_____________________________________

(Printed Name)

My commission expires __________________.

Form #3406

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