(Application for Authority to do Business pursuant to
31 MRSA §712.3
to accompany Application for Transfer of Authority)
FIRST:
The name of the limited liability company* is __________________________________________________________.
SECOND:
(Check box only if applicable)
This is a professional limited liability company** qualified pursuant to
13 MRSA Chapter 22-A
to provide
the following professional services:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
THIRD:
If the real limited liability company name is not available, the fictitious name under which it proposes to apply for
authority to do business in the State of Maine is (If not applicable, so indicate.)
______________________________________________________________________________________________.
Form MLLC-5 accompanies this application.
A fictitious name is a name adopted by a foreign limited liability company authorized to transact business in this
State because its real name is unavailable pursuant to §603-A.
FOURTH:
(For a professional limited liability company only)
All of the professional limited liability company’s members and managers, if any, are licensed in one or more states to
render a professional service disclosed in its application.
FIFTH:
Date of organization ________________________ Jurisdiction of organization _______________________________
Address of the registered or principal office, wherever located, is:
_______________________________________________________________________________________________
(physical location - street (not P.O. Box), city, state and zip code)
_______________________________________________________________________________________________
(mailing address if different from above)
SIXTH:
The foreign limited liability company validly exists as a limited liability company under the laws of the jurisdiction of
its organization. The nature of the business or purposes to be conducted or promoted in the State of Maine is
______________________________________________________________________________________________.
SEVENTH:
The name of its Registered Agent, an individual Maine resident or a corporation, foreign or domestic, authorized to do
business or carry on activities in Maine, and the address of the registered office shall be:
_______________________________________________________________________________________________
(name)
_______________________________________________________________________________________________
(physical location - street (not P.O. Box), city, state and zip code)
_______________________________________________________________________________________________
(mailing address if different from above)
The Secretary of State of Maine is an agent upon whom service of process may be served pursuant to §722.3.
FORM NO. MLLC-12-1 (1 of 2)