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Form Mnpca-Iib - Statement Of Revocation Of Voluntary Disso L Utio N Proceedings - State Of Maine

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Fee

$5.00

DOMESTIC

NONPROFIT CORPORATION

STATE OF MAINE

STATEMENT OF

REVOCATION

OF VOLUNTARY

DISSO L UTIO N PROCEED IN GS

Deputy Secretary of State

(Written Consent of Members or Directors)

A True Copy When

Attested

By Signature

Deputy Secretary of State

(Name of Corporation)

Pursuant to 13-B MRSA §1102, the undersigned corporation executes and delivers for fIling the following statement of revocation of

voluntary dissolution proceedings previously authorized:

FIRST:

The names and respective addresses of its officers and directors are:

Address

President

Treasurer

Secretary

Clerk

Directors :

(List additional directors on reverse side)

SECOND:

("X" one box only) Exhibit A attached hereto is a copy of the written consent signed by:

All

members

of the corporation

entitled

to vote.

D All directors of the corporation, there being no members or no members entitled to vote.

11DRD:

The address of the registered office of the corporation in the State of Maine is

(street, city, state am zip code)

Form Mnpca-Iib - Statement Of Revocation Of Voluntary Disso L Utio N Proceedings - State Of Maine