This space reserved for office use. 302 . (Revised 05/11) FOI'IlI Submit in duplicate to: Secretary of State P.O. Box 13697 Austin, TX 78711-3697 (512) 463-5555 FAX: 512M63-5709 Filing Fee: $25 I. The foreign entity is a The name is F I LED of the Secretary of State of Texas In the Office SEP 23 2014 Application for Registration for a Nonprofit Corporation or Cooperative Association [Z] nonprofit corporation. 0 Corporations Section cooperative assocIation. Association for Responsible Altem.lives 10 Workers' Compensation, Inc. A foreigll cooperative nssocintlon name must contain the word "cooperative" or rut abbreviation oflhnt word. 2A. If the entity filing the registration is a foreign cooperative association and the name of the cooperative in its jurisdiction of formation does not contain the word "cooperative," or an abbreviation thereof, then the name of the cooperative with the word 01' abbreviation that it elects to add fot' use in Texas is: 2B. The entity name is not available in Texas. The assumed name under which the entity will qualify and transact business in Texas is: 3. Its federal employer identification number is: _4:..:6'--04:..:3"'6::.6°:.:1:.:5_ _ _ _ _ _ _ _ _ _ _ _ __ Federal employer identification numbet· information is not available at this time. o Delaware 4. It is organized under the laws of: (set forth state or foreign country) and the date of its formation in that jurisdiction is: _1;..2.:;:/2:..:3.:..;/2;..:0-'-1;;..3 _ _ _ === _______ ml/JddJyyyy 5. As of the date of filing, the undersigned certifies that tho named entity currently exists as a valid foreign filing entity of the stated type under the laws ofthejurisdiction of its formation. 6. The purpose or pUt'poses of the corporation that it proposes to pursue in the transaction of business In Texas are set forth below. Business league/tmde association The corporation also certifies that it is authorized to pursue such stated purpose or purposes in the state or country under which it is incorporated. 7. The date on which the foreign entity intends to transact business in Texas, or the date on which the foreign entity first transacted business in Texas is: ,.::u:r.po:::n,.,9f,u::::a:::1i",fi:;::ca:::ti",o,:,n=========_ __ mm/ddlyyyy Lale/ees may apply (SOB Instruclfons). 8. The principal office address of the entity Is: 919 Congress Avenue, Suite 425 Austin TX Address City Slale US 78701 RECEIVED Form 302 ; \ SEP 232014 Secretary of State :'- . ,t' ,. ,'.~.i:'~,t'~·. "' ' j .: t'l, .. :; .... '_J~.LG Complete item 9A or 9B, but not both. Comp!ete Itom 9C. [{] 9A. The initial registered agent is an organization (cannot be entity named above) by the name of: Richard W. Evans OR o 98. The initial t'egistered agent is an individual resident of the state whose name is: First Nawe Last Name SIif/iX 9C. The business address of the registered agent and the registered office address is: 919 Congress Avenue, Suite 425 Strcet Addl'ess Austin City TX 78701 Siale Zip Cod. 10. The entity hereby appoints the Seoretary of State of Texas as its agent for service of process under the circumstances set forth in section 5.251 of the Texas Business Organizations Code. II. The name and address of each person on the board of directors is: Director 1 See Attached First Name M.l. Last Name SI!/JIX " Street or Mal/(ng Address City Stale COllntry ... Zip Code Director 2 First Name M.l. Street or Mailing Address City Last Name SI!/fIx Stats Country Zip Cod. Director 3 First Name M.I. Simi or Mailing Address City Last Name S!!/JIx Siale Country Zip Code 12. The name, address, and office title of each officer or managel'ial official are: See Attached First Name M.l. Street or Mailing Address Flrsl Name Street or Maf/{ng Address rom1302 CUy M'/. Office Title Last Name Stale Zip Code Office Title Lasl Name City Country State COfll1fry Zip Code First Name M.I. Street or Mailing Address First Name 13. 0 o Olflee Till, Stale Clly M.I. Stl'cct or Mailing Address Last Name Last Name COUlltly Zip Code Olflee Title City Stale COI/Illry Zip Code The foreign entity is a nonprofit corporation and has members. The foreign entity is a nonprofit corporation and has no members. Supplemental Provisions/lnfol'mation Text Area: IThe nttnched addendum lfany.ls incorcorated herein by reference.l Effectiveness of Filing (Select either A. B; or C.) . A. 0 This document becomes effective when the document is filed by the secretary of state. B. 0 This document becomes effective at a latcr date, which is not more than ninety (90) days from the date of signing. The delayed effective date is: C. 0 This document takes cffect upon the occurrence of a future event 01' fact, other than the passage of time. The 90 th day after the date of signing is: ITho fullow'". woo<", r,,, wHl"," "",,m,,' ,"0 fo "'" ,ffoct '" "" ~". '="b,' b,'ow, Execution The undersigned affirms that the person designated as registered agent has consented to the appointment. The undersigned signs this document subject to the penalties imposed by law for the submission ofa materially false 01' fraudulent instrument and cet1ifies under penalty of peljury that the undersigned is authorized under the provisions of law governing the entity to execute the filing instrument. Date: tlj( /fY William Minick, Secretary Printed or typed name of authorized person. Form 302 Attachment to Application fOr Registmtion for a Nonprofit Corporation or Cooperative Association Item 11. Names and Addresses of Directol'S: Address Diana Craft 16414 San Pedro, Suite 800 San Antonio, TX 78232 Valerie Wilhite Franco 1000 Lowe's Boulevard Mooresville, NC 28117 Max Koonce P.O. Box 5020 Rogers, AR 72757 Janine Kl'ai 1700 7th Avenue, Suite 1500 Seattle, WA 98101 Julie Layton N56 W17000 Ridgewood Drive . Mel)(lInonee Falls, WI 53051 Chris Mandel, RF, CPCU 456 Summit Oaks Drive Nashville, TN 37221 William Minick 8117 Preston Road, Suite 530 Dallas, TX 75225 . Jeny Mul'phy 5910 N. Central Expressway, Suite 500 Dallas, TX 75206 Blake Y. Stock 14785 Preston Road, Suite 350 Dallas, TX 75254 Mark Whitehead 615 J.B. Hunt Corporate Drive Lowell, AR 72745 Allen Wingfield 300 Phillipi Road Columbus, OH 43228 Mark Wooten 1390 Enclave Parkway Houston, TX 77077 William Zachry 11555 Dublin Canyon Road Pleasanton, CA 94588 Megan Zoller III Westwood Place, Suite 200 Brentwood, TN 37207 52094300000210850689.1 Item 12. Names, Addresses and Titles of Officers: Name Address Title Valerie Wilhite Franco 1000 Lowe's Boulevard Mooresville, NC 28117 Vice President Max Koonce P.O. Box 5020 Rogers, AR 72757 Chairman Janine Kral 1700 7th Avenue, Suite 1500 Seattle, WA 98101 President William Minick 8117 Preston Road, Suite 530 Dallas, TX 75225 Secretary Blake Y. Stock 14785 Preston Road, Suite 350 Dallas, TX 75225 Treasurer 52094) 000002 10850689.1 ASSOCIATION FOR RESPONSmLE CONSUMERS, INC. 130 E. JOHN CARPENTER FREEWAY IRVING, TEXAS 75062 September 18, 2014 Office of the Secretary of State Corporations Section P.O. Box 13697 Austin, Texas 78711-3697 Dear Sirs: Association for Responsible Consumers, Inc. hereby consents to the use in Texas of the corporate name "Association for Responsible Alternatives to Workers Compensation, Inc." by a Delaware nonprofit corporation ofthat same name. Thank you. Sincerely, ~h~ Ralph Wolfe President STlllk