Form Mnpca-13a - Nonprofit Corporation Amended Annual Report - 2012
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3Filing Fee $35.00
NONPROFIT CORPORATION
STATE OF MAINE
AMENDED ANNUAL REPORT
_______________________
Deputy Secretary of State
____________________________________________
A True Copy When Attested By Signature
______________________________________
(Name of Corporation)
_______________________
Deputy Secretary of State
Pursuant to
13-B MRSA
§1301-C, the undersigned corporation executes and delivers the following Amended Annual Report:
FIRST:
The jurisdiction of its incorporation is
_________________________________________________________________.
SECOND:
The original annual report was filed on (date) ___________________________________.
THIRD:
The information has changed as follows (attach additional pages, if necessary):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
FOURTH:
This information changed on (date) _______________________________.
An amended annual report may be filed by the corporation to change information currently on file. The time for filing an
st
amended annual report is from the date of the original filing until December 31
of that filing year.
If you are changing officer or director information, you must provide the name, title and complete physical address of this
individual. Additionally, you must provide the information currently on file and indicate how it changed.
Form No. MNPCA-13A (1 of 2)
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