Form Mbca-12a - Amended Application For Authority To Do Business

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Filing Fee $70.00
(If amending ONLY Item FOURTH filing fee $35.00)
FOREIGN
BUSINESS CORPORATION
STATE OF MAINE
AMENDED APPLICATION FOR
_____________________
AUTHORITY TO DO BUSINESS
Deputy Secretary of State
A True Copy When Attested By Signature
_____________________
______________________________________
Deputy Secretary of State
(Name of Corporation)
Pursuant to
13-C MRSA
§1504, the undersigned foreign corporation executes and delivers the following Amended Application for
Authority to do Business:
FIRST:
The jurisdiction currently appearing on the record is ___________________________________________________.
SECOND:
The date on which it was authorized to do business in the State of Maine is _________________________________.
THIRD:
The name of the foreign corporation has been changed to (if no change, so indicate):
______________________________________________________________________________________________.
If the real corporate name is not available, the fictitious name under which it proposes to apply for authority to do
business in the State of Maine is (if not applicable, so indicate):
______________________________________________________________________________________________.
Form MBCA-5 accompanies this application.
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.
FOURTH:
The new address of its principal office, wherever located, is (if no change, so indicate):
_______________________________________________________________________________________________
(street, city, state and zip code)
_______________________________________________________________________________________________
(mailing address if different from above)
FIFTH:
The new state or country under whose law the foreign corporation is now incorporated (if no change, so indicate):
_______________________________________________________________________________________________
A certificate of existence or a document of similar import duly authenticated by the Secretary of State or
other official having custody of corporate records in the state or country under whose law the foreign
corporation is now incorporated accompanies the change in Item FIFTH. The certificate of existence must
have been made not more than 90 days prior to the delivery of this application for filing.
FORM NO. MBCA-12A (1 of 2)

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