TO: ___________________(1)___________________________

___________________(2)___________________________

Notice is hereby given that the undersigned, ______(3)________, of ________(4)___________, who holds the exclusive right to use the corporate name, "_____________(5)_______________," for a one-hundred-twenty (120) day period ending ________(6)_________, has been transferred to __________(7)________ of ______(8)_______

____________(9)________________