Document NyKk6dQnrrJeQZ1N3LYr8RRD

Affidavit to Be Filed By Foreign Corporation Pursuant to the provisions of "The General and Business Corporation Law" of Missouri, 1959, upon increase of a corporation's stated capital and surplus as represented by its property located in and business transacted in Missouri as shown on balance sheet for last fiscal or calendar year, the undersigned Corporation submits the following affidavit. (File even if no tax is due.) STATE OF...... ........................ ......' COUNTY OF Oakland rSS* Reginald T. Bentley _ Qf Bigelow-Liptak Corporation President or Vice-President a corporation didy incorporated under the laws of the State of ........ ...................................... and qualified to do business in Missouri since 1..' ___ (File No. being duly sworn upon his oath states that he is .... V.ice-Pres ident _ of said corporation, and that: President or Vice-President (9-A) The aggregate number of shares which it has authority to issue, itemized by classes, par vaiue of shares, shares without par value, and series, if any, within a class, is: Class Common Series (if any) None Number of Shares 2,000 Par value per share or statement that shares are without par value No Par Value (10-A) The aggregate number of its issued shares, itemized by classes, par value of shares, shares without par value, and series, if any, within a class, is: Class Common Series (if any) None Number of Shares 2,000 Par value per share or statement that shares are without par value No Par Value (11-A) The amount of stated capital and the amount of paid-in surplus of the corporation as defined by "The General and Business Corporation Law of Missouri" is: Stated Capital.. Paid in Surplus Total_____ $200,000.00 s 16,449.04 $___216,449.04 (12-A) Total value of all the property of the corporation is................... $------- 5*408,959.03 (13-A) Total value of all the property of the corporation located in Mis souri is. 717.28 (14-A) Gross amount of business of the corporation transacted by it everywhere is .......'.................................................... ----------------------------- -------- $-----1.1*171.XP40.91.. (15-A) Gross amount of business of the corporation transacted by it i:. the State of Missouri is ........................................................................................S............ 5.9. '''A) The amount of stated capital and surplus of the corporation (including all surplus, such as paid-in and earned surplus) is............:........... $---------2- 1-2--4--0- --3--4--1-.--1-5--- (17-A) The proportion of staied capital and surplus represented by the corporation's property in Missouri is......... ............................................................ S.......................... 5-t. .... That the address of its registered office in Missouri is $.?.-y and the name of its registered aeent at such address is.......Q....T.A...Q..EPfi3r35i.n..S.yst,eic .............................. >X ' T EJ3Q36KKK- Vice-President Subscribed and sworn to before me this............. --9----.......... day of .........--------------------------------- 19--7 My commission expires: o ................ ...................................................................... Wayne County j Notarj' Public Acting in Oakland Cour.ry j . r., Uottvy V/nyr.e Ccur.ry, Mich. r.\v 0 ? rn m *s ^" E."~' .* -v*y 1 d, 1 JT uly 16................. ...............,19..67.