Form Mnpca-3 - Change Of Registered Agent Onl Y Or Change Of Registered Agent And Registered Office Page 2

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DATED
*By
(signature)
(type or print name and capacity)
*By
(signature)
(type or print name and capacity)
THE FOLWWING
SHALL BE COMPLETED BY THE REGISTERED AGENT UNLESS TInS DOCUMENT IS
ACCOMPANIED BY FORM MNPCA-18 (§304.3. or §1212.1-A.).
The undersigned hereby accepts the appointment as registered agent for the above named nonprofit corporation.
REGISTERED AGENT
DATED
(tyPe
or print
name)
(signature)
For Registered Agent which is a Corporation
Name of Corporation
By
(aud1orized signature)
(type or print name and capacity)
*If this is a domestic corporation, this document M!l§I
be signed by
(1) the ~
or Secretarv OR
(2) the President or a vice-pres. together with the Secretarv or an ass't. sec., or a 2nd certifying officer OR
(3) if no such officers, then a majority of the Directors OR
(4) if no such directors, then the Members.
*If this is a foreign corporation, this document MUST be signed by any duly authorized individual.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MNPCA-3 Rev.8/2000
TEL. (201) 287-4195

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