Form Cons - Articles/certificate Of Inter-Entity Consolidation Page 3

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Must Be Completed By The Second Participant To The Consolidation
_______________________________________________________________________
_____________________________
(name and type of participating business entity)
(dated)
___________________________________________________
___________________________________________
(authorized signature)
(type or print name and capacity)
___________________________________________________
___________________________________________
(authorized signature)
(type or print name and capacity)
Must Be Completed By The Third Participant To The Consolidation
_______________________________________________________________________
_____________________________
(name and type of participating business entity)
(dated)
___________________________________________________
___________________________________________
(authorized signature)
(type or print name and capacity)
___________________________________________________
___________________________________________
(authorized signature)
(type or print name and capacity)
(Copy this page, and modify participant number, if more signature spaces are needed.)
Instructions For Required Signatures
Resulting Business Entity
The Registered Agent must complete an acceptance of appointment form.
Limited Partnerships
If this is a limited partnership, this document MUST be signed by
(1) at least one general partner OR
(2) any duly authorized person.
The execution of this certificate constitutes an oath or affirmation, under the penalties of false swearing under
Title 17-A, section
453.
Limited Liability Companies
If this is a limited liability company, this document MUST be signed by
(1) at least one manager OR
(2) at least one member if the limited liability company is managed by the members OR
(3) any duly authorized person.
The execution of this certificate constitutes an oath or affirmation, under the penalties of false swearing under
Title 17-A, section
453.
_____________________________________________________________________________________________________________
Please remit your payment made payable to the Maine Secretary of State.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. CONS (3 of 3) Rev. 7/1/2003
TEL. (207) 624-7752

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