Form Mbca-14 - Certificate Of Excuse 2004
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1Filing Fee $40.00
DOMESTIC
BUSINESS CORPORATION
STATE OF MAINE
CERTIFICATE OF EXCUSE
_____________________
Deputy Secretary of State
A True Copy When Attested By Signature
_____________________
______________________________________
Deputy Secretary of State
(Name of Corporation)
Pursuant to
13-C MRSA
§1621.4, the undersigned corporation executes and delivers the following Certificate of Excuse:
FIRST:
The corporation has ceased to transact business.
SECOND:
The corporation is not indebted to this State for failure to file an annual report and to pay any fees or penalties
accrued. If the excuse process is completed on or before June 1st, then the Annual Report covering the previous
calendar year is not required.
THIRD:
The effective date of the certificate of excuse (if other than the date of filing of the certificate of excuse):
_______________________________.
DATED _________________________
*By __________________________________________________
(signature of any duly authorized person)
__________________________________________________
(type or print name and capacity)
*This document MUST be signed by any duly authorized officer OR the clerk.
(13-C MRSA
§121.5)
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-14 (1 of 1) Rev. 8/1/2004
TEL. (207) 624-7752
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