SORPORATION ANNUAL REPORT Please return completed form to: TENNESSEE SECRETARY OF STATE Annual Report Filing Fee Due: ‘Atte: Annual Report 20, ne changos are made block to the registered agente, SIP cent Aer btn Foor $40, any changes are made n xk ot the Fagitered Spent ina Sodas foot Rome a -TURRENT FISCAL YEAR CLOSING MONTH 12 ie areal aeectacnsmeenre 04/01/03 (stot oF are covTRaL ame” 9624651 in] KAA MAG ADRESS OF oreNaTON ssa on CTT OF CORPRATON WARSHA, BLACKBURN FOR CONGRESS, INC. TENNESSEE ets uRRAY CANE SkeNruooss ‘TH "57027 [@27=56 or ounce uate ARE D__06/05/2002 NON PROFIT 7 ora ee 6108 HURRAY LANE, BRENTWOOD, TN. 37027 a |B CHANGE OF PRINCIPAL ADDRESS: 4 STREET ow stare CODE + 4 8 » ‘ng mo evans sone, wea Con, OF TH PROB, SECRETARY AD TER RNGPAL OFC : cineca Sheers eeesoae) & Tie ‘Name ‘Business Address Gily, Siate, Zip Code + 4 o : G. Kline Preston, I 4525 Harding Rd. Nashville, TN 37205 ‘Gecreiary Tom Nelms 7195 Chester Rd. Fairview, TN 37062 (6) BOARD OF DIRECTORS (NAMES, BUSINESS ADDRESS INCLUDING ZIP CODE) (ATTACN ADOITIONAL SHEET IF NECESSARY.) Gh same as avove, [] wow, om usTED BeLow: Tame ‘Baines Adare Doug Grindstafé 6210 Relle Riave D - - = (8 A Nae oF REGISTERED AGENT AS APPEARS ON SECRETARY OF STATE RECORDS = CHARLES. C.-BLACKBURN x eGLARLES SiessPA AGA BU BM creamy or stare neconos x SERS MURRAY ChANE to BRENT HE Mend Nave BOUR Reisen omnet. ot 2 6: unos or neoaren cea Se 8 (i )CHAMGE OF REGISTERED OFFICE (Strest Address: = & em, (Saw Tn cam a) = ) A THIS.BOX APPLIES ONLY TO NONPROFIT CORPORATIONS. OUR RECOROS REFLECT THAT YOUR NONPROFIT CORPORATION I A PUBLIC BENEFIT OR A MUTUAL BENEFIT CORPORATION AS INDICATED I BLANK OR INCORRECT, PLEASE CHECK APPROPRIATE Box CJ pueuc C) MUTUAL PUBLIC a Fa Tmessee npeCOORepaTON Rua Om BOK Foam CIRRSOIS sinter " DATE 7 | A 4/20/07 (9 yp Roue oF sa TMU OF SIGNER @ “THIS REPORT MUST BE DATED AND SIGNED ** seat fv. 008 INSTRUCTIONS: won. ttatntn.u/eoe/ or 618-744-206 oa wreSORPORATION ANNUAL REPORT Please return completed form to Annual Report Filing Fee Due: Ati: Anoual Report ‘TENNESSEE SECRETARY OF STATE 320, no changes are made in block #5 the retard agentotie SIP ehh ete we roe 520: any changes are made Sk pe segaeressponoies. ina Sesser Yoyer Neahehs Ee mar racn oncom wane op woreccmomon — OU ]oy 1 aero aT Ca nazacei {2h NAME ANG MAILING ADORESS OF CORPORATION [a8 STATE OR COUNTRY OF INCORPORATION HARSHA BLACKBURN > INC. | NNESSEE, WARSHA BLACKBURN FOR CONGRESS, INC Te BRENTWOOD, TN 37027 D___04/05/2002 NON PROFIT 6103 MURRAY LANE, BRENTWOOD, TN 37027 STREET omy STATE ZIPCODE + 6 (nae AN BUSINESS ADDRESS. WCLUDWG ZIPCODE, OF TE PRESUENT, SECRETARY AND OTHER PRINCIPAL OFCERE Ta Ta ane a Muakiked Fae i 5 — = [7195 Chester Rd. Fairview, TN 37062 ‘Tom Nelms i c { (8 BOARG OF ORECTORS NAMES. BUSINESS ADDRESS INEWUDNE ZIP CODE "7a 2 same AS AROWE, WOW, OR USTED BELOW (© A MAME OF REISTERED AGENT AS APPEARS ON SECRETARY OF STATE RECORDS: eB STARES Sect AGES Bl sccaerany oF sta conas ae cP UB RAN ANE to BERMEURR Ror ue SLR8 ecssrenen omce er a (ome oF ecerenee ace emp Soo ‘coum 7) A TWis 80% 4#PLIES ONLY To NONPROFIT CORPORATIONS OUR RECORDS REFLECT THAT YOUR NONPRORT CORPORATION If A PUBLIC Iowan on nc SE CHecK APPROPRIATE BOK CJ PuBuc CI wuTUAL pusic. 7” 2 ira remgpaee nepoioucofodarion Pane Giea Box Feu CI ReuGOUS a at LK 1/20/07 Tor rercnpin? nau OF sienem in) ee oF seven i w Beeeidone - 6 THIS REPORT MUST BE DATED AND SIGNED ** 6997" £09SORPORATION ANNUAL REPORT a semreremnemeercee aaa SERNESSEE SECREYARY OF STATE Annual Report Fling Foe Due eee eel 520, (fro changes are made in black #6 to the registered agertotie, or SIP ght Avene Wh oe {40 any changos are mace in block #8 tothe registered agent, ‘ition R. Snodgrass Tower d ceeneeneri Nasite, TH 37be3 ca . vemoreomoone (514 /O1]05 [1 SECRETARY OF STATE CONTROL Naber 0424651 {2h) RAE AND MAILNG ADORESS OF CORPORATION JB) TATE OR COUNTRY GF INCORPORATION YARSHA BLACKBURN FOR CONGRESS, INC. TENNESSEE 6103 MURRA’ BRENTWOOD, TN” $7027 [ac AbD Om GuaNGE MAILING ADDRESS D___06/05/2002 _NON PROFIT {3 A panciPaL ADDRESS ELON Ty, STATE, ZF COPE 6103 MURRAY LANE, BRENTWOOD, TN 37027 8 CHUNG OF PRINCIPAL ADDRESS STREET ony STATE (i nae ano BUSINESS ADORESE, woLUDIG ZIP CODE. OFTHE PRESIDE, SECRETARY AND OTHER PRINCIPAL OFFICERS arrach acornonat SHEcT IF RECESSARY) Te cad Sana TSE Tp Coma G. Kline B: V__4525 Harding Ral Naghville, TN_37205 __| ‘Tom Nelms | 7195 Chester Ra. Fairview, TN 37062 i Doug Grindstaff ile Riev Brentwood, (9 ator tn soa ca OL ERT oF AT NCO GABLES Ses ABS Btaccrerate oF stat neconos ALOT RBEAY LANE o RERMEAQD dBc BLE Dorn mee ia mao ws aay em aaae [A THs BOK APPLES ONLY TO NONPROFTT CORPORATIONS. UR RECORDS REFLECT THAT YOUR NONPROFIT CORPORATION 1 A PUBLIC Trova on connect, Pues ontek arrormiate goe CI rusuc C] wuruaL PUBLIC Bir a roecsatenaflocus cparoralin PEASE CHEEK DOK FON CORIOOS 4/20/07 TM OF SIGNER Iv President THIS REPORT MUST BE DATED AND SIGNED INSTRUCTIONS: wowattesatee” or 46741-2206 OLtz e€09‘CORPORATION ANNUAL REPORT ‘Annual Report Please return completed form to: Fee Due: Tene Ser SEEREVARY OF Stare nual Repo {22 no canges are made in lok tthe eltred sontotic, or Si elghth Averive N. 6th Floor . any changes are made in lock #8 to the repstered spentioicn, Wim Snodgrass Tower seiemannianiaes Nashvle, TN 97be3 oS pee 12 ‘TWiS REPORT 1S DUE ON OR BEFORE: OYfa/oe (0 SECRETARY OF STATE CONTROL mar 0424651 (2A) NAME AND WALING ADDRESS OF CORPORATION ia) STATE OR COUTRY OF NCORFORATION WARSHA BLACKBURN » INC. TENNESSEE HEYA RAAGRaY Fam coneess, ne BRENTWOOD, TN 37027 (26) ADO OR CHANGE MAILING ADDRESS D___04/05/2002 _NON PROFIT @ 'A PRINCIPAL ADDRESS INCLUDING CITY, STATE, ZP CODE 6103 MURRAY LANE, BRENTWOOD, TN 37027 1 CHANGE OF PRINCIPAL ADORESS: STREET cry STATE ZIPCODE + 4 (8 NAME AND BUSINESS ADDRESS, INCLUDING ZIPCODE. OF THE PRESIDENT, SECRETARY AND OTHER PRINCIPAL OFFICERS, (ATTACH ADOITIONAL SHEET IF HECESSAAY 7 Tame Beara Rar Gi, Sala Zp Come FH Peesaet a 5 ; ‘Seaway ‘Tom Nelms 7195 Chester Rd. | Fairview, TN 37062 (9 BOARD OF DIRECTORS (WANES, BUSINESS ADDRESS INCLUDING ZIPCODE} (ATIAGH ADDITIONAL SHECT IFNECESSARY) ER Ce same ns asove, C] none, OF UstED et.ow 22 = Tas Beans ASE Gy Bae Bee TR ey [——Doug-Crindstafe_| 6210 Relic nieve De- Brentwood, T8-37627___— 3 (A NAME OF REGISTERED AGENT AS APPEARS OH SECIETARY OF THE RECOROS mR CHARLES C. BLACKBURN = 8. REGISTERED aDbvicss AS APPUARS CM SECRETARY OF STATE AéCORDE Ana CALERA chit fo BERNE N GO suf ne 3202 Ke cerenen omce - (1) cxamot oF nccisenso acex — (JOHAN OF REGISTERED orc ere Aas a (cin (Gia) TW (ip Cote +0, (out |e) 4 1s 80x APPLIES ONLY To NONPROFT CORPORATIONS, ou IR RECOROS REFLECT THAT YOUR NONPROFIT CORPORATION IS A PUBLIC BENEFIT OF A MUTUAL BENEFIT CORPORATION AS INDICATED. 'F BLANC OR INCORRECT, PLEASE CHECK APPROPRIATE BOX C] PuBuC C] MUTUAL PUBLIC a tra roaster Rausok oolporTon iaseOmEKeoxF AR CI RGoR rm {=| a 4/20/07 arrange or oe (01) TE oF SIGNER G. Kline Preston, tv President @ * THIS REPORT MUST BE DATED AND SIGNED ** sso $848 INSTRUCTIONS: wonton uaa! oF #15.741.298 non an TL9S S09‘CORPORATION ANNUAL REPORT ene re Annual Report Fing ee Due TENNESSEE SECRETARY OF 9A ‘32, f no changes are made in block #6 to the registered agentiofce, oF JP efahth Averoe W. th Foor $0 anychangos are made in Sock gw te reg seed spenotice Arie Secaynes twee aber a iz a wrorraon over wcrne OY [01 [OZ Gicanannror sca caraal SCe nazacel AI ta AN WH ORES OF COMPOEATON Ga GR CORTY OF POPEATER WARSHA BLACKBURN FOR CONGRESS, INC. TENNESSEE 6103 MURRA) BRENTWOOD, TN’"'S7027 (ae) ABO OR CHANGE WAILNG ADDRESS D___04/05/2002 NON PROFIT {GA PRINCIPAL ABORESS INCLING GT, STATE, 2° COOE 6103 MURRAY LANE, BRENTWOOD, TN 37027 2. CHANGE oF PrIciPaL ADDRESS: STREET omy STATE ZIPCODE + 4 (4 ABE AN BUSINESS ADDRESS, WCLLDWG ZIP CODE. OF THE PRESIDENT, SECRETARY AO CTHER PRINCIPAL OFFICERS (ATACH ACOMTIONAL SHEET IF CESAR Te Ta a iy ae Ep mre Ig. Kline Preston, IV 4525 Harding Rd.| Nashville, TN 37205 eee Tom Nelms 7195 Chester Rd.| Fairview, TN 37062 {9 80AR0 OF ORECTORS (AMES, BUSINESS ADORESS CLUDING 2° CO0E) (ATTACH ADDITIONAL ETI NECESSARY) [Sk sane as above, Lowe, on usteD anew: 6210 Balle Biove. yy ORL e238 (6) ANAME OF REGISTERED AGENT AS APPEARS ON SECRETARY OF STATE RECORDS: Ss 2 = ARLES sess Ss AES Bt accartany or sare meconos ge RE UBRAY chANS to RE REE Read Rate BEEF eaten omce ae (0) exawer oF necnstenc Acta: (4 Yenase oF RECTED OF tA om (Sim) TH ip Case + (omy (7) A.TW8 BOX APPLES ONLY TO NONPROFT CORPORATIONS CUR RECORDS REFLECT THAT YOUR NONPROFIT CORPORATION ISA PUBLIC Uenarit of A MUTUAL Benet CORPORATION AE NCEATED. Ir pcan on INCORRECT PLEASE cnceK APPmOPRare Gox Cl pvsuc Cl] MUTUAL 1 eA Tibor varrrernb ac eromes VU oF woven G. Kline Presto, IV President @ ** THIS REPORT MUST BE DATED AND SIGNED * TLE EL09uot Oe an Fa Gen tis Oo BO com, Mag, : ‘ Ne) APR 20. HH 2 eS APPLICATION FOR REINSTATEMENT! © Department of State FOLLOWING ADMINISTRATIVE, Corporste Pigs DISSOLUTION REVOEATION \ SF SiATE 312 Eight Avenue North ‘Foor, William R, Snodgrass Tower Nase, S723 Pursuant to the provisions of Section 48-24-203 or Section 48-26-303 of the Tennessee Business Corpo ration Act or Section 48-64-203 or Section 48-65-303 of the Tennessee Nonprofit Corporation Act, this appli- cation is submitted to the Office of the Secretary of State, State of Tennessee, for reinstatement. 1. The name of the corporation is _Marsha Blackburn for Congress, Inc] (Name change if applicable). 2, The effective date of ks administrative dssouuton/revocations A=[A2COD (must be month, Gay, and year). 3. The ground(s) for the administrative dissolution/revocation D did not exist. € hasihave been eliminated. NOTE: Please mark the applicable box] The corporate name as listed in number one (1) salisfies the requirements of Tennessee Code Anno- tated Section 48-14-101 or 48-54-101, as appropriate. 5, The corporation control number as assigned by the Secretary of State, if known is, [NOTE (APPLIES TO FOR-PRO! for filing, the Division of Busines: PORATIONS ONLY): Prior to this document being accepted erie will request tax clearance verification from the Tennessee Department of Revenue that the fu.siness hes properly fted all reports and paid all required taxes and penalties. If we cannot obtain such tax cisztarice verification from the Department of Revenue, this docu- ‘ment will be rejected and returned: to the applicant } 4/2oson Signature Date President Signer's 10 P jro Ff Kline Preston, IV Name (typed or printed) 55-4499 (Rew. 701) Fring Foe: $70.00 ROA 1678 ELBE" £09Secretary of State Division of Business Services ‘6th Floor, William R. Snodgrass Tower TELEPHONE CONTACT: (615) 741-2286 Nashville, Tennessee 37243 FILE DATE/TIME: 04/20/07 1431. EFFECTIVE DATE/TIME: 04/20/07 1431 CONTROL NUMBER: 0424651 To: HARSHA BLACKBURN FOR CONGRESS, INC. 6108 MURRARY LANE. BRENTWOOD, TN 37027 RE: WARSHA BLACKBURN FOR CONGRESS, INC. APPLICATION FOR REINSTATERENT TT HAS BEEN DETERMINED THAT THE ATTACHED APPLICATION FOR REINSTATEMENT GONTAINS THE INFORMATION REQUIRED BY STATUTE) THEREFORE THE ABOVE. CORPORATION 15 HEARBY REINSTATED, OR IF A FOREIGN CORPORATION, ITS. CERTIFICATE OF AUTHORITY IS REINSTATED. WHEN CORRESPONDING WITH THIS OFFICE OR SUBMITTING DOCUMENTS FOR FILING, PLEASE REFER TO THE CORPORATION CONTRO! SUNDER GIVEN ABOVE. FOR: APPLICATION FOR REINSTATEMENT ON DATE: 04720707 Fees FROM: 2 coo . ton Lay cro RECEIVED. 470-0 $0.00 HARDING RD. 1. H $525, HARD TOTAL PAYMENT RECEIVED, $70.00 NASHVILLE, TN 37205-0000 RECEIPT NUMBER: 00006161066 ACCOUNT NUMBER: 00561455, yt don RILEY C. DARNELL, SECRETARY OF STATE 6Te0"0S09‘CORPORATION ANNUAL REPORT Pass return complatd frm te: TEWNESSEE SECRETARY OF STATE Anoual Report Filing Fee Due Tenses seca "20, mo changes are maga in block #6 to the regitared agente, oF BP pans Aver Wh Floor 440, it any changes are made in block #6 to the registered sponte. ihr h Sree Tower Nesta CURRENT RACAL YEAR CLOG MONT 12 ‘H00 FPORT «BUS Cn OR SET: 04701708 {SECRETARY F STATE conTaGL omer 0424651 > (2A 9 WANG ADDRES OF CORPORATION [TATE OR CORT ROOTORRIGR 3 MARSHA BLACKBURN FOR + INC. TENNESSEE FS ® Las tye RAts LANE keer coal eee Sa 2 SRENTWOOD, TN’ 37027 [Bevan ox ounce mnatone = 2 Bo © 8 2g 8 SE 2 f D 04/05/2002 NON PROFIT rt TG) A PRINEIPAL ADDRESS MCWOING NY, STATE, BP EOOE 6103 MURRAY LANE, BRENTWOOD, TN 37027 1 OUNCE OF PRINCIPAL ADDRESS: ‘STREET omy STATE ZIPCODE + 4 (Wh we AND BUSINESS ADOREDE, CLUDING 29 CODE OF THE PRESIDENT, SECRETARY AND OTHER PRINCIPAL OFFICERS. [ATTADH ADOTIONAL SHEET IF MECEESARYD =F eae Page | Zara Aehns | iy, Sioa, Bip Cae =F Ah (@) BOARO OF DIRECTORS (WalES, QUSINESS ADDRESS INGWOING ZW CODE) ATTACH ADOITIONAL ENEET IF MECESSARY.) (Ese ne avove, L) wont, o8 USTED BELOW: cond coma Gi am ae [Deng Loriadstat? |ezie Be le [ape De| Brenpwocd, TATE PRR F {© A (AME OF REGISTERED AGENT AS APSARS ON SECRETARY OF STATE RECORDS: SHAE LES Sead AFP St sucnerny oF sta RECORDS ‘ OBS UREAY ANE to RESMEHOD Rien Rue BbBR kecisenco omer (0 exnmot of atsaente soca (i.Jouamcr OF REEITEAES ox mt Aa fom, ‘fine TH ip Coon +8 ay 7 7 Box appucs omy To yWeNONT CoMoRATONE, OM RECOAESROLCT TAT YOUR HONOR CORPORATIONS APLC | ‘Fhtan on CORRECT, PLEASE CnGeK APPmPRUATE Box CJ pom C] MITA PUBLIC ‘Bia TOmeSSEE REUGOUS CORPORATION FLASEOHEEXBOXIFBUIN UO AELGIOUS ose efisfex- an shen ey i 3 esrcunt : @ = THIS REPORT MUST BE DATED AND SIGNED **‘CORPORATION ANNUAL REPORT Please return completed form to: ‘Anal Report Filing Fee Due: TENNESSEE SECRETARY OF STATE $20, i no changes are made in block 46 to the registered agentoffice, o 512 Resa L. Parks Avenue, 6th Floor 540, if any changes are made in block #6 to the registered sgenUatice Wiliam R. Snodgrass Tower Nashville, TN 27263 ‘GURREAT CAL EAR CLOSING Mow 12 cerca ene on on aro 04701709 (1) SECRETARY OF STATE CONTROL Ramer 0424651 (@A] HAE AND MAILING ADDRESS OF CORPORATION TRB STATE OR COUNTRY OF NCDRFORATION HARSHA BLACKBUi » INC. SEE WABSHAUBLACKBURN FOR CONGRESS, INC TENNES: BRENTWOOD, TN. 37027 [ae ADD On CHANGE MAILING ADDRESS Po. Box 3750 Breatsood ,- TW D__06/05/2002 NON PROFIT 37024 'G)__A PRINCIPAL ADORESS NELUDWG GIY. STATE iP COOE 6103 MURRAY LANE, BRENTWOOD, TN 37027 1 CIUNGE OF PRINCIPAL ADDRESS. arma omy STATE ZIPCODE + 4 ZLOE"06S9 (4) ule AD BUSINESS ADDRESS, NCLUDING ZIP COOE, OF THE PRESIDENT, SECRETARY ANO OTHER PRINCIPAL OFFICERS: (ATTACH ADDITIONAL SHEET TF MESSARY Tae a ‘Bases art] iy. Baie Sp came ne. ET | BA533 thers INashwile, THO) 372 ay ms Ta SEH Fearn ao, MS 37 OC LC (9 90ARO OF ORECTONS wars BUSINESS ADDRESS WELUDIG Zi CODE) (AAC AOHIna SNR MECEEARY) Kame : ‘Buuness AsoresS i ‘Gily, Sine, Zip Code +4 (©) A NAME OF REGISTERED AGENT AS APPEARS ON SECRETARY OF STATE RECORDS. oe ES Sica ACA BU RN ccncrny oF sta nEconoe ARR RIBEAY chANE fo REEMINOD eT Mae 3292 Zecsreaa ornce (0) emma or neoereRED Acta: (1 )oHaNCE OF REGITERED OFFICE Bt Aton BY oo a Sais (4 TW BOK APPLIES ONLY To NONPROFIT CORPORATIONS OUR RECORDS REFLECT THAT YOUR NONPROFIT CORPORATION 1S A PUBLIC BENEFIT Of A MUTUAL BENEFIT CORPORATION AS MDICATED. IF BLAM OR INCORRECT, PLEASE CHECK APPROPRIATE @OX C] PueUC C) MUTUAL PUBLIC 8 IFA TENNESSEE REUGIOUS CORPORATION, PLEASE CHECK BOK AM CT REGIONS oe Ait LAE, ala 104 corre ere ea roger somn * "THIS REPORT MUST BE DATED AND SIGNED "> sss tr) NSTRUCTIONS: wom sttatnunncal or 18-74-288 moan