Form Mllc-Denial - Statement Of Denial Of Authority
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LIMITED LIABILITY COMPANY
STATE OF MAINE
STATEMENT OF DENIAL
_____________________
OF AUTHORITY
Deputy Secretary of State
(for a Maine LLC)
A True Copy When Attested By Signature
_____________________
Deputy Secretary of State
______________________________________
(Name of Limited Liability Company)
Pursuant to
31 MRSA
§1543, the undersigned hereby denies the statement of authority originally filed on _________________________
that named me as an authorized person or that named the position I hold as authorized to enter into transactions on behalf of the above-
named limited liability company.
I further state that I have furnished the limited liability company with a copy of the statement of denial as required under
31 MRSA
§1543.3.
DATED __________________________
___________________________________________________
____________________________________________________
(signature)
(type or print name and capacity)
Pursuant to
31 MRSA
§1676.1D, statement MUST be signed by the person denying the statement of authority.
The execution of this certificate constitutes an oath or affirmation under the penalties of false swearing under
17-A MRSA
§453.
Please remit your payment made payable to the Maine Secretary of State.
Submit completed form to:
Secretary of State
Division of Corporations, UCC and Commissions
101 State House Station
Augusta, ME 04333-0101
Telephone Inquiries: (207) 624-7752
Email Inquiries:
CEC.Corporations@Maine.gov
Form No. MLLC-Denial 7/1/2011
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