| PTO Form 2197 (Rev 09/2005) |
| OMB No. 0651-0056 (Exp 09/30/2011) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 76645666 |
| LAW OFFICE ASSIGNED | LAW OFFICE 113 |
| MARK SECTION | |
| MARK | FAXAPP |
| OWNER SECTION (current) | |
| NAME | FREEDOM NATIONAL INSURANCE SERVICES, INC. |
| STREET | 1249 E. Katella Avenue |
| CITY | Orange |
| STATE | California |
| ZIP/POSTAL CODE | 92867 |
| COUNTRY | US |
| PHONE | (714) 289-9500 |
| CORRESPONDENCE SECTION (current) | |
| ORIGINAL ADDRESS | FREEDOM NATIONAL INSURANCE SERVICES 1249 E KATELLA AVE ORANGE California 92867-5019 United States (714) 289-9500, ext. 203 bijan@freedomgeneral.com |
| NEW OWNER ADDRESS | |
| INTERNAL ADDRESS | Suite 315 |
| STREET | 18952 MacArthur Boulevard |
| CITY | Irvine |
| STATE | California |
| ZIP/POSTAL CODE | 92612 |
| COUNTRY | United States |
| PHONE | (714) 289-9500 |
| CURRENT CORRESPONDENCE ADDRESS | |
| NAME | Bijan Abdi |
| FIRM NAME | Freedom National Insurance Services, Inc. |
| INTERNAL ADDRESS | Suite 315 |
| STREET | 18952 MacArthur Boulevard |
| CITY | Irvine |
| STATE | California |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 92612 |
| PHONE | 949-862-8401 |
| FAX | 877-675-8833 |
| SIGNATURE SECTION | |
| SIGNATURE | /bijan abdi/ |
| SIGNATORY NAME | Bijan Abdi |
| SIGNATORY DATE | 05/31/2007 |
| SIGNATORY POSITION | President |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Thu May 31 16:37:23 EDT 2007 |
| TEAS STAMP | USPTO/COA-XX.XXX.XX.XX-20 070531163723487063-766456 66-3602c4ecc71f116999affd 1e60762a4938-N/A-N/A-2007 0531163238554078 |