Form Mllc-17 - Certificate Of Correction Page 2
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1
2MAN A G ER ( S) /MEMBER
( S) *
DATED
(signattlre)
(type or print name atxl capacity)
For Manager(s)/Member(s) which are Entities
Name of Entity
By
(authorized signature)
(type or print name aIxI capacity)
IF 11llS CERTIF1CATE
OF CORRECTION
NAMES A NEW REGISTERED
AGENr,
mE
FOLWWING
SHALL BE
COMPLETED
BY mE
REGISTERED
AGENr
UNLESS 11llS DOCUMENT
IS ACCOMPANIED
BY FORM MLLC-18
(§607 .2.).
The undersigned hereby accepts the appointment as registered agent for the above-named domestic limited liability
company.
REGISTERED AGENT
DATED
(signature)
(tyPe or print name)
For Registered Agent which is a Corporation
Name of Corporation
By
(authorized signattlre)
(tyPe or print name and capacity)
*Certificate MUST be signed by
(I)
at least one mana2er OR
(2)
at least one member if the limited liability company is managed by the members OR
(3)
any duly authorized person.
The execution of this certificate constitutes an oath or aff1rInation 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. MLLC-17
Rev.7/2000
TEL. (207} 287-4195
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