Amended Application For Authority To Do Business Form (Page 2 of 2) in pdf

Amended Application For Authority To Do Business Form Page 2

DATED

MANA

G ER(S)/MEMBER(S)

* *

(signature)

(type or print name aOO capacity)

For Manager(s)/Member(s) which are Entities

Name of Entity

(authorized signature)

(tyPe or print name and capacity)

*The limited liability company name as used in the State of Maine must contain one of the following:

"Limited Liability Company",

"L.L.C." or "LLC" (§603.1.A.). If the addition of these words is the Q!!ly difference from the limited liability company's true name in

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

an assumed name only pursuant to §603.2.B. this application must be accompanied by form MLLC-12F.

**Certificate MUST be signed by

(I)

at least one mana&er 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 affirmation under the penalties of false swearing under Title 17-A, section 453.

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

101 STATE HOUSE STAnON, AUGUSTA, ME 04333-0101

FORM NO. MLLC-12A

Rev.8/2000

TEL. (201) 287-4195

Amended Application For Authority To Do Business Form Page 2