Trade Name
Trade Name
Trade Name
1. For the reporting entity delivering this statement, its ID number, true name, form of entity and the
jurisdiction under the law of which it is formed are
ID Number 20201331000
(Colorado Secretary of State ID number)
Jurisdiction Colorado .
2. The trade name under which such entity transacts business or conducts activities or contemplates
transacting business or conducting activities in this state is
Redeemer .
4. (If the following statement applies, adopt the statement by marking the box and include an attachment.)
(If the following statement applies, adopt the statement by entering a date and, if applicable, time using the required format.)
The delayed effective date and, if applicable, time of this document are .
(mm/dd/yyyy hour:minute am/pm)
Notice:
Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery, under penalties of perjury, that such document is
such individual's act and deed, or that such individual in good faith believes such document is the act and deed
of the person on whose behalf such individual is causing such document to be delivered for filing, taken in
conformity with the requirements of part 3 of article 90 of title 7, C.R.S. and, if applicable, the constituent
documents and the organic statutes, and that such individual in good faith believes the facts stated in such
document are true and such document complies with the requirements of that Part, the constituent documents,
and the organic statutes.
6. The true name and mailing address of the individual causing this document to be delivered for filing are
_HEIDI L MUELLER
(Last) (First) (Middle) (Suffix)
_P.O. Box 1097
(Street number and name or Post Office Box information)
(If the following statement applies, adopt the statement by marking the box and include an attachment.)
This document contains the true name and mailing address of one or more additional individuals
causing the document to be delivered for filing.
Disclaimer:
This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice,
and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy
minimum legal requirements as of its revision date, compliance with applicable law, as the same may be
amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should
be addressed to the user’s legal, business or tax advisor(s).