Form Mbca-5 - Business Corporation Statement Of Intention To Do Business Under An Assumed Or Fictitious Name - 2004

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Filing Fee for an Assumed Name $125.00
Filing Fee for a Fictitious Name $40.00
BUSINESS CORPORATION
STATE OF MAINE
STATEMENT OF INTENTION
_____________________
TO DO BUSINESS UNDER
Deputy Secretary of State
AN ASSUMED OR FICTITIOUS NAME
A True Copy When Attested By Signature
_____________________
______________________________________
Deputy Secretary of State
(Real Name of Corporation)
Pursuant to
13-C MRSA
§404, the undersigned corporation executes and delivers the following Statement of Intention to do
Business Under an Assumed or Fictitious Name:
FIRST:
("X" one box only.)
assumed name
(13-C MRSA
§404.1)
fictitious name
(13-C MRSA
§404.2)
The corporation intends to transact business under the assumed or fictitious name of
______________________________________________________________________________________________.
Please note: A fictitious name is a name adopted by a foreign corporation authorized to transact business in this
State because its real name is unavailable pursuant to
13-C MRSA
§401.
Complete the following if applicable:
SECOND:
If the assumed name is to be used at fewer than all of the corporation's places of business in this State, the
location(s) where it will be used is (are):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
THIRD:
(Foreign Corporation Only)
Jurisdiction of incorporation _____________________________________________________ and the date on which
the corporation was authorized to transact business in Maine _____________________________________________.
FORM NO. MBCA-5 (1 of 2)

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