Form Mnpca-3-Ncra - Noncommercial Registered Agent - Statement Of Appointment Or Change - 2008 Page 2
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1
2FOURTH:
Complete this Item as follows based on your selection in Item First:
A.
The new address of the noncommercial registered agent (provide address information only);
B.
The name and address of the new noncommercial registered agent (provide name and address information);
C.
The name of the new noncommercial registered agent (provide name only); OR
D.
The new name of the current noncommercial registered agent (provide name only).
_______________________________________________________________________________________________
(name of new noncommercial registered agent or new name of current noncommercial registered agent)
_______________________________________________________________________________________________
(physical street address, not a P.O. Box – city, state and zip code)
_______________________________________________________________________________________________
(mailing address if different from above)
FIFTH:
Pursuant to
5 MRSA
§108.3, the registered agent as listed above has consented to serve as the registered agent for this
nonprofit corporation.
SIXTH:
The undersigned noncommercial registered agent of the following corporation(s) has notified each corporation of the
change indicated in Item First A or D:
Name of Nonprofit Corporation
Jurisdiction
Date incorporated or authorized in Maine
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Names of additional corporations attached hereto as Exhibit ___, and made a part hereof.
Dated _________________________
*By ____________________________________________________
(signature)
____________________________________________________
(type or print name and capacity)
*This statement MUST be signed as follows:
(1) if Item First, A or D was selected, then by the noncommercial registered agent OR
(2) if Item First, B or C was selected, then by any duly authorized officer
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. MNPCA-3-NCRA (2 of 2) 7/1/2008
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