Form Mllc-12 - Application For Authority To Do Business (Page 2 of 2) in pdf

Form Mllc-12 - Application For Authority To Do Business Page 2

FIFTH:

The name and business, residence or mailing address of each manager, if any, is:

NAME

ADDRESS

Names and addresses of additional managers are attached hereto as Exhibit

.' and

made

a part

hereof.

SIXTH:

The date on which the foreign limited liability company first did, or intends to do, business in the State of Maine is

SEVENTH:

This application is accompanied by an original certificate executed not more than 90 days prior to the delivery of the

application

for fIling by the official

having custody of the records pertaining

to limited

liability

companies in the

jurisdiction

of organization showing that the limited liability company is in good standing or the equivalent.

DATED

AUTHORIZED SIGNA TURE(S)**

( signawre )

(type or print name aOO capacity)

For Authorized Signature(s) on behalf of Entities

Name of Entity

(aud1orized signattlre)

*The limited liability company name as used in the State of Maine must contain one of the following:

"Limited Liability Company",

"L.L.C." or "LLC" (§603.1.A.). If the addition of these words is the QillY difference from the limited liability company's true name in

its jurisdiction of organization, no further action is required. If the limited liability company proposes to do business in this State under

an assumed name only pursuant to §603.2.B., this application must be accompanied by form MLLC-12F.

**Application MUST be signed by at least one authorized person (§712.2.).

The execution of this application constitutes an oath or affIrmation under the penalties of false swearing under Title 17-A, section 453.

SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECnON, SECRETARY OF STATE,

101 STATE HOUSE STAnON, AUGUSTA, ME 04333-0101

FORM NO. MLLC-12

Rev.7/2000

TEL. (201) 287-4195

Form Mllc-12 - Application For Authority To Do Business Page 2