Form Mllc-Conv - Statement Of Conversion
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STATE OF MAINE
STATEMENT OF CONVERSION
(Relating to a Limited Liability Company)
_____________________
Pursuant to
31 MRSA §1647
the undersigned organization
Deputy Secretary of State
executes and delivers the following statement that it has
converted into another organization.
A True Copy When Attested By Signature
_____________________
Deputy Secretary of State
FIRST:
Converting Organization
The name of the converting organization: ____________________________________________________________
The form of the converting organization: ____________________________________________________________
The jurisdiction of the converting organization’s governing statute: _______________________________________
The date of its organization: _____________________________________________________________________
SECOND:
Converted (Resulting) Organization
The name of the converted (resulting) organization: ____________________________________________________
The form of the converted (resulting) organization: ____________________________________________________
The jurisdiction of the converted (resulting) organization’s governing statute: _______________________________
The date of its organization: ______________________________________________________________________
The address of its principal office is: _______________________________________________________________
THIRD:
The date the conversion is effective under the governing statute of the converted organization: __________________
FOURTH:
The conversion was approved as required by
31 MRSA Chapter 21
and the limited liability company agreement.
FIFTH:
The conversion was approved as required by the governing statute of the converted organization.
SIXTH:
(Foreign Converted Organization Only)
The foreign converted organization acknowledges it may be served with process in this State by certified mail and the
address of its principal office for the purposes of
§1648.3
is:
____________________________________________________________________
(
Principal office address)
____________________________________________________________________
(
Principal office address)
Form No. MLLC-Conv (1 of 2)
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