Form Mllc-3-Ncra - Noncommercial Registered Agent - Statement Of Appointment Or Change - 2011 Page 2

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FOURTH:
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
§§105.2
or 108.3, the registered agent as listed above has consented to serve as the registered
agent for this limited liability company.
SIXTH:
The undersigned noncommercial registered agent of the following limited liability company(s) has notified each limited
liability company of the change indicated in Item First A or D:
Name of Limited Liability Company
Jurisdiction
Date authorized or organized in Maine
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Names of additional limited liability companies attached hereto as Exhibit ___, and made a part hereof.
Dated _________________________
*By ____________________________________________________
(authorized 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 a person authorized by the limited liability company
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-3-NCRA (2 of 2) 7/1/2011

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