| No. C 100038 | Due no later than Nov 30, 2009
Annual Report Form | 2. Registered Agent and Address (NO PO BOX) |
| Return to: | PAUL
MONTREUIL 8882 N GOVERNMENT WAY STE L HAYDEN LAKE ID 83835 |
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SECRETARY OF STATE 700 WEST JEFFERSON PO BOX 83720 BOISE, ID 83720-0080 |
1. Mailing Address: Correct in this box if needed.
IDAHO INDEPENDENT BANK PAUL MONTREUIL 8882 N GOVERNMENT WAY STE L PO BOX 2950 HAYDEN LAKE ID 83835 |
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| 3. New Registered Agent Signature:* | ||
| NO FILING FEE IF RECEIVED BY DUE DATE |
| 4. Corporations: Enter Names and Business Addresses of President, Secretary, and Directors. Treasurer (optional). |
| Office Held | Name | Street or PO Address | City | State | Country | Postal Code |
| DIRECTOR | GARY MAHN | 5260 N. SAWYER AVE. | BOISE | ID | USA | 83714 |
| DIRECTOR | JERALD J. JAEGER | PO BOX 6200 | COEUR D'ALENE | ID | USA | 83814 |
| DIRECTOR | TERRY GUSTAVEL | 480 N. LATAH | BOISE | ID | USA | 83706 |
| DIRECTOR | ROY L. EIGUREN | 801 W. IDAHO STREET, SUITE 100 | BOISE | ID | USA | 83702 |
| DIRECTOR | MICHAEL COUGHLIN, M.D. | 901 N. CURTIS RD., SUITE 503 | BOISE | ID | USA | 83706 |
| DIRECTOR | ROD B. COLWELL | 1260 W. RIVERSTONE DRIVE | COEUR D'ALENE | ID | USA | 83814 |
| DIRECTOR | ARTHUR BROWN | 10836 N. SPLIT ROCK RD. | HAYDEN | 83835 |
| DIRECTOR | JACK W. GUSTAVEL | 1260 W. REVERSTONE DRIVE | COEUR D'ALENE | ID | USA | 83814 |
| SECRETARY | PAUL H. MONTREUIL | 8882 N. GOVERNTMET WAY | HAYDEN | ID | USA | 83835 |
| PRESIDENT | KURT R. GUSTAVEL | 401 W. FRONT STREET | BOISE | ID | USA | 83714 |
| 5. Organized Under the Laws of: | 6. Annual Report must be signed.* | |
| ID C 100038 | Signature: Paul Montreuil | Date: 11/23/2009 |
| Name (type or print): Paul Montreuil | Title: Sr. VP, Cashier and Secretary | |
| Processed 11/23/2009 | * Electronically provided signatures are accepted as original signatures. | |