Form Mllc-13a - Amended Annual Report - 2012
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1
2Filing Fee $85.00 for Maine; $150.00 for Foreign
LIMITED LIABILITY COMPANY
STATE OF MAINE
AMENDED ANNUAL REPORT
(Maine or Foreign LLC)
_____________________
Deputy Secretary of State
_____________________________________________
A True Copy When Attested By Signature
______________________________________
_____________________
(Name of Maine or Foreign Limited Liability Company)
Deputy Secretary of State
Pursuant to
31 MRSA
§1666, the undersigned limited liability company executes and delivers the following Amended Annual Report:
FIRST:
The jurisdiction of its organization is
_________________________________________________________________.
SECOND:
The date the original annual report was filed is ______________________________________.
THIRD:
The information that has changed (attach additional pages, if necessary):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
FOURTH:
The date this information changed is_________________________________.
An amended annual report may be filed by the limited liability company to change information currently on
st
file. The time for filing an amended annual report is from the date of the original filing until December 31
of
that filing year.
If you are changing a contact person, you must provide the name and complete physical address of this individual.
Additionally, you must provide the information currently on file and indicate how it changed.
Form No. MLLC-13A (1 of 2)
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