TO: ______________________________

_______________________________________________________________ (address)

Pursuant to _________________________ (state section and code), notice is hereby given of the intention of [individual] , a resident of _____________________ Country, State of _________________ , who is the wife of_______________________ (name of husband), to apply to the ____________________________________ (court) of the Country of __________________ for a judgment declaring her a sole trader and enabling her to carry on the business of __________________ (nature of business), in her own name and on her own account. Said business to be conducted at _______________________________________________ (address), City of _________

Country of __________________, State of ______________ .

Said application will be made on ____________________ (date).

Dated: __________________

_________________________

(Signature)