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'e <br />State of California <br />Secretary of State Q, - <br />STATEMENT OF INFORMATION <br />(Domestic Stock and Agricultural Cooperative Corporations) <br />FEES (Filing and Disclosure): $25.00, if amendment, see Instructions. <br />IMPORTANT — READ INSTRUCTIONS BEFORE COMPLETING THIS FORM <br />00100954 <br />FILED <br />In the office of the Secretary of State <br />of the State of Caltiomla <br />MAR ] o 2008 <br />This Space For Flllnp Use Only <br />1. CORPORATE NAME (Please do not atter If name Is preprinted)Ls— <br />C <br />GV i -n-�G �---,\i-e-- Sn -�' nC • <br />t o c(2 Ov��)Pu-�as CIC30(7� <br />DUE DATE: <br />NO CHANGE STATEMENT (Not applicable if agent address of record is a RID. Box address See Instructions.) <br />2. [] If there has been no change In any of the Information contained In the last Statament of Information filed with the California Secretary of <br />State, check the box and Droc eed to Item 16. <br />If there have been any dianges to the Information contained in the fast Statement of Infiomnation filed with the Cahforrlla Secretary of State, <br />or no statement has been previously filed this form must be completed In its enbrety <br />COMPLE i r- ADDRESSES FOR THE FOLLOWING (Ca not abbreviate the name dthe cty. Items 3 and 4 cannot be P.O. &o;ms ) <br />g gDpR1 SSQF PVE OFFIJE C STATEICCODE <br />4 STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY CITY STATE ZIP CODE <br />CA <br />5 MAILING ADDRESS OF CORPORATION, IF DIFFERENT THAN ITEM 3 CITY STATE ZIP CODE <br />NAMES AND COMPLETE ADDRESSES OF THE FOLLOM:ING OFFICERS (Tile corporation must have these three officers. A comparable title <br />for the is officer may be added, however, the preprinted trues on this form must not be altered.) <br />e, CHIEF E>;ECU i iY�.OFFiCER! I _ ADDRESSC ,� 1 _ STATE Z I CODE_ <br />7 SECRETARYI ADDRESS ` CITY STATE ZIP,�ODE <br />5 G �. t � <br />8 CHIEF FI ClA1 FICERI ADDRESS C STATE ZIP CODE <br />'2S 33L <br />CA <br />A,1 v� SQL do G ✓� <br />NAMES AND COMPLETE ADDRESSES OF ALL DIRECTORS, INCLUDING DIRECTORS WHO ARE ALSO OFFICERS (The <br />must have at least one director. Attach additional pages, If neca3sa ) <br />Cry STATE 114- ZIE E <br />A <br />. n C G� <br />10 NAME ADDRESS CITY / ` STATE ZIP CODE <br />11 NAME ADDRESS CRY STATE ZIP CODE <br />12 NUMBER OF VACANCIES ON THE 40ARD OF DIRECTORS IF ANY. <br />AGENT FOR SERVICE OF PROCESS (If the agent Is an lndlvtdual, the agent must reside In Califomia and Item 14 must be ccmpleted with a Caldomia <br />street address (a PO. Box address q not acceptable) If" agent is another corporation, the agent must have on file wdh the Caldomia Secretary of State a <br />certificate pur3uant to Corporations Code sedlon 1505 and Item 14 must be IeR blank) <br />13 NAME OFA ENT FOf.SERVICE O PROCE <br />14 STREET ADDRESS OFF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF INDIVIDUAL CITY STATE ZJP CODE <br />t)pQ Q � C, CA <br />TYPE OF BUSINESS <br />15 DESCRIBE THE TYPE OF BUSINESS OF CORPORATIO <br />OL'Le CI o a>n <br />to BY SUBMITTING THIS STATEMENT OF WFORMATIDN TO THE CALIFORNV SECRETARY OF STATE, THE CORP RATION S THE INFORMATION <br />� <br />�r�Ay\ t <br />HEREIG�ty ✓�-\C1 NTS, is TRUE AND CORRECT <br />TYPE/PRINT NAME OF PERSON COMPLETING FORM TITLE SIGNATURE <br />SI -200 WC REV 01/2008 APPROVED BY SECRETARY OF STATE <br />