MEMBER(S)*
DATED
(signattlre)
(type or print name)
(signature)
(type or print name)
(signature)
(type or print name)
For Member(s) which are Entities
Name of Entity
By
(authorized signature)
(type or print name aIxi capacity)
Name of Entity
By
(authorized signature)
(type or print name and capacity)
Name of Entity
By
(audlorized signattlre)
(type or print name and capacity)
* Articles ~
be signed by
(I)
a majority in interest of the members OR
(2)
any duly authorized person.
The execution of this certificate constitutes an oath or affmnation under the penalties of false swearing under Title 17 -A, section 453.
SUBMIT COMPLETED FORMS TO: CORPORATE EXAMINING SECTION, SECRETARY OF STATE,
101 STATE HOUSE STATION, AUGUSTA, ME 04333-0101
FORM NO. MLLC-IIL
Rev.8/2000
TEL. (207} 287-4195