Form Mbca-3 - Change Of Clerk And/or Registered Office 2004 Page 2
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1
2FIFTH:
The undersigned clerk of the following corporation(s), who has changed the address of the registered office OR who
has changed his or her name, has notified each corporation of the change indicated in Item Third A or D:
Name of Corporation
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Names of additional corporations attached hereto as Exhibit ___, and made a part hereof.
Note:
The following must be signed by the proper person as designated below.*
DATED _________________________
*By ____________________________________________________
(signature)
____________________________________________________
(type or print name and capacity)
Acceptance of Appointment of New Clerk
The undersigned hereby accepts the appointment as clerk for the above-named domestic business corporation.
DATED __________________________
_________________________________________________
___________________________________________________
(signature of clerk)
(type or print name)
Note:
If this document changes the clerk and the new clerk does not sign, Form
MBCA-18 (13-C MRSA
§501.3) must accompany
this document.
*This document MUST be signed as follows:
(1) if Item First, A. was selected, then by the Clerk OR
(2) if Item First, B. was selected, then by any duly authorized officer or the new Clerk OR
(3) if Item First, C. was selected, then by any duly authorized officer or the new Clerk OR
(4) if Item First, D. was selected, then by the Clerk.
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. MBCA-3 (2 of 2) Rev. 8/1/2004
TEL. (207) 624-7752
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