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Original Appointment of Statutory Agent <br />The undersigned, being at least a majority of the incorporators of <br />Healthy Lakewood Foundation <br />(Name of Corporation) <br />hereby appoint the following to be Statutory Agent upon whom any process, notice or demand required or permitted by <br />statute to be served upon the corporation may be served. The complete address of the agent is: <br />Susan O. Scheutzow <br />(Name of Statutory Agent) <br />1375 East Ninth Street <br />(Mailing Address) <br />Cleveland OH 44114 <br />(Mailing City) (Mailing Stale) (Mailing ZIP Code) <br />Must be signed by <br />the incorporators or I <br />a majority of the (Signature) <br />incorporators. <br />(Signature) <br />(Signature) <br />Acceptance of Appointment <br />The Undersigned, I Susan O. Scheutzow named herein as the <br />(Name of Statutory Agent) <br />Statutory agent for <br />IHealthy Lakewood Foundation <br />(Name of Corporation) <br />hereby acknowledges and accepts the appointment of statutory agent for said corporation. <br />Statutory Agent Signature <br />(Individual Agent's Signature / Signature on Behalf of Business Serving as Agent) <br />5328 Page 4 of 7 Last Revised: 1010112017 <br />