Form Mllp-12 - Application For Authority To Do Business

Form Mllp-12 - Application For Authority To Do Business - 2001 Page 2

FIFTH:

The name and business, residence or mailing address of the contact partner is:

NAME

ADDRESS

____________________________________

____________________________________________________

SIXTH:

The date on which the foreign limited liability partnership first did, or intends to do, business in the State of Maine is

___________________.

SEVENTH:

This application is accompanied by an original certificate executed not more than 90 days prior to the delivery of the

application for filing by the official having custody of the records pertaining to limited liability partnerships in the

jurisdiction of organization showing that the limited liability partnership is in good standing or the equivalent.

DATED __________________________

AUTHORIZED SIGNATURE(S)**

___________________________________________________

____________________________________________________

(signature)

(type or print name and capacity)

For Authorized Signature(s) on behalf of Entities

Name of Entity __________________________________________________________________________________________________

By ________________________________________________

____________________________________________________

(authorized signature)

(type or print name and capacity)

*The limited liability partnership name as used in the State of Maine must contain one of the following: "Limited Liability Partnership",

"L.L.P." or "LLP" (§803.1.A.). If the addition of these words is the only difference from the limited liability partnership's true name

in its jurisdiction of organization, no further action is required. If the limited liability partnership proposes to do business in this State

under an assumed name only pursuant to §803.2.B., this application must be accompanied by form MLLP-12F.

**Application MUST be signed by at least one authorized person (§852.2.).

The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under Title 17-A, section 453.

SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,

101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101

FORM NO. MLLP-12

Rev. 4/16/2001

TEL. (207) 624-7740

Form Mllp-12 - Application For Authority To Do Business - 2001 Page 2